How much rates vary
Facilitymedian $51 · 10th to 90th $51 to $234Professionalmedian $49 · 10th to 90th $35 to $100
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | None (both parts) | $51.29 | $51.29 | $56.23 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $21.88 Median $34.67 Typical High $64.57 | Professional | QW · Waived lab test | $21.88 | $34.67 | $64.57 |
BCBS North Carolina Setting Facility Modifier None Typical Low $114.82 Median $134.90 Typical High $162.18 | Facility | None | $114.82 | $134.90 | $162.18 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $38.90 Median $48.98 Typical High $70.79 | Professional | None (both parts) | $38.90 | $48.98 | $70.79 |
BCBS North Carolina Setting Professional Modifier QW · Waived lab test Typical Low $46.77 Median $51.29 Typical High $64.57 | Professional | QW · Waived lab test | $46.77 | $51.29 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $158.49 Typical High $234.42 | Facility | None | $75.86 | $158.49 | $234.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $51.29 | $51.29 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Facility | None | $51.29 | $51.29 | $61.66 |
Medcost Setting Professional Modifier None (both parts) Typical Low $89.13 Median $100.00 Typical High $120.23 | Professional | None (both parts) | $89.13 | $100.00 | $120.23 |
Oscar Health Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Professional Modifier None (both parts) Typical Low $21.38 Median $30.90 Typical High $52.48 | Professional | None (both parts) | $21.38 | $30.90 | $52.48 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $39.81 Typical High $47.86 | Professional | 26 · Professional part | $38.02 | $39.81 | $47.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $151.36 Typical High $239.88 | Professional | 50 · Both sides | $151.36 | $151.36 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 51 · Multiple procedures | $50.12 | $50.12 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $19.95 Typical High $32.36 | Professional | 80 · Assistant surgeon | $19.95 | $19.95 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.13 Median $14.13 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $14.13 | $14.13 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.13 Median $14.13 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $14.13 | $14.13 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $14.13 Typical High $22.39 | Professional | AS · PA/NP assist | $14.13 | $14.13 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $47.86 Typical High $87.10 | Professional | TC · Technical part | $47.86 | $47.86 | $87.10 |
Where North Carolina sits
The same service costs 3.1 times more in Alaska than in Maine. 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· 46th of 51
$48.98
AK $102ME $33.11
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.