How much rates vary
Facilitymedian $17 · 10th to 90th $17 to $17Professionalmedian $17 · 10th to 90th $17 to $31
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 Professional Modifier 26 · Professional part Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 26 · Professional part | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $8.71 Median $8.71 Typical High $9.55 | Professional | TC · Technical part | $8.71 | $8.71 | $9.55 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $8.71 Typical High $25.70 | Professional | 26 · Professional part | $7.76 | $8.71 | $25.70 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $13.18 Typical High $30.20 | Professional | TC · Technical part | $10.23 | $13.18 | $30.20 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 26 · Professional part | $7.41 | $7.41 | $7.41 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | TC · Technical part | $10.23 | $10.23 | $10.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $6.76 Median $7.94 Typical High $11.22 | Professional | 26 · Professional part | $6.76 | $7.94 | $11.22 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7.41 Median $9.33 Typical High $13.80 | Professional | TC · Technical part | $7.41 | $9.33 | $13.80 |
United Setting Professional Modifier 26 · Professional part Typical Low $7.59 Median $9.12 Typical High $17.78 | Professional | 26 · Professional part | $7.59 | $9.12 | $17.78 |
United Setting Professional Modifier TC · Technical part Typical Low $9.12 Median $12.59 Typical High $23.44 | Professional | TC · Technical part | $9.12 | $12.59 | $23.44 |
15 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 Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None (both parts) Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | None (both parts) | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $8.32 Typical High $9.12 | Professional | 52 · Reduced service | $8.32 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.63 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.63 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $79.43 | Professional | None (both parts) | $17.38 | $17.38 | $79.43 |
Cigna Setting Professional Modifier None (both parts) Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None (both parts) | $17.78 | $17.78 | $17.78 |
Medcost Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $21.38 | Facility | None | $16.60 | $16.60 | $21.38 |
Medcost Setting Professional Modifier None (both parts) Typical Low $11.75 Median $16.98 Typical High $28.18 | Professional | None (both parts) | $11.75 | $16.98 | $28.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.75 Median $8.51 Typical High $16.98 | Professional | 51 · Multiple procedures | $5.75 | $8.51 | $16.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.34 Median $3.39 Typical High $6.76 | Professional | 80 · Assistant surgeon | $2.34 | $3.39 | $6.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.62 Median $2.40 Typical High $4.79 | Professional | 81 · Minimal assistant surgeon | $1.62 | $2.40 | $4.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.62 Median $2.40 Typical High $4.79 | Professional | 82 · Assistant surgeon, no resident | $1.62 | $2.40 | $4.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.62 Median $2.40 Typical High $4.79 | Professional | AS · PA/NP assist | $1.62 | $2.40 | $4.79 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $8.51 Median $17.78 Typical High $35.48 | Professional | None (both parts) | $8.51 | $17.78 | $35.48 |
United Setting Professional Modifier None (both parts) Typical Low $16.98 Median $21.38 Typical High $43.65 | Professional | None (both parts) | $16.98 | $21.38 | $43.65 |
Where North Carolina sits
The same service costs 2.3 times more in Wisconsin than in North Carolina. 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· 51st of 51
$17.38
WI $39.81NC $17.38
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.