How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $151.36 | Facility | None | $52.48 | $52.48 | $151.36 |
Aetna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $52.48 Typical High $53.70 | Professional | None (both parts) | $35.48 | $52.48 | $53.70 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $48.98 Median $89.13 Typical High $123.03 | Professional | None (both parts) | $48.98 | $89.13 | $123.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $43.65 Median $75.86 Typical High $112.20 | Professional | None (both parts) | $43.65 | $75.86 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $44.67 Typical High $52.48 | Facility | None | $37.15 | $44.67 | $52.48 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.11 Median $56.23 Typical High $79.43 | Professional | None (both parts) | $33.11 | $56.23 | $79.43 |
United Setting Professional Modifier None (both parts) Typical Low $41.69 Median $54.95 Typical High $97.72 | Professional | None (both parts) | $41.69 | $54.95 | $97.72 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $16.98 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $5.37 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.55 | $5.25 | $5.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $22.39 Typical High $33.88 | Professional | 26 · Professional part | $15.49 | $22.39 | $33.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $50.12 Median $85.11 Typical High $169.82 | Professional | 50 · Both sides | $50.12 | $85.11 | $169.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $28.18 Typical High $57.54 | Professional | 51 · Multiple procedures | $16.60 | $28.18 | $57.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $11.22 Typical High $22.91 | Professional | 80 · Assistant surgeon | $6.61 | $11.22 | $22.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.68 Median $7.94 Typical High $15.85 | Professional | 81 · Minimal assistant surgeon | $4.68 | $7.94 | $15.85 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.68 Median $7.94 Typical High $15.85 | Professional | 82 · Assistant surgeon, no resident | $4.68 | $7.94 | $15.85 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.68 Median $7.94 Typical High $15.85 | Professional | AS · PA/NP assist | $4.68 | $7.94 | $15.85 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $33.88 Typical High $51.29 | Professional | TC · Technical part | $23.44 | $33.88 | $51.29 |
Where North Carolina sits
The same service costs 2.6 times more in Nebraska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 4th of 51
$79.43
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.