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 |
|---|---|---|---|---|---|
BCBS North Carolina Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $251.19 | Facility | None | $208.93 | $208.93 | $251.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | None (both parts) | $194.98 | $194.98 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $190.55 | Professional | None | $112.20 | $120.23 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Medcost Setting Professional Modifier None (both parts) Typical Low $151.36 Median $177.83 Typical High $190.55 | Professional | None (both parts) | $151.36 | $177.83 | $190.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $269.15 Typical High $288.40 | Professional | 50 · Both sides | $229.09 | $269.15 | $288.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $89.13 Typical High $95.50 | Professional | 51 · Multiple procedures | $75.86 | $89.13 | $95.50 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $35.48 Typical High $38.02 | Professional | 80 · Assistant surgeon | $30.90 | $35.48 | $38.02 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $25.12 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $21.38 | $25.12 | $26.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $25.12 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $25.12 | $26.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $25.12 Typical High $26.92 | Professional | AS · PA/NP assist | $21.38 | $25.12 | $26.92 |
4 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 26 · Professional part Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 26 · Professional part | $61.66 | $75.86 | $75.86 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | SH · Second concurrent infusion | $75.86 | $75.86 | $75.86 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | SJ · Third+ concurrent infusion | $75.86 | $75.86 | $75.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | TC · Technical part | $107.15 | $114.82 | $114.82 |
Where North Carolina sits
The same service costs 9.8 times more in Tennessee than in Massachusetts. 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· 31st of 36
$178
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.