How much rates vary
Facilitymedian $41 · 10th to 90th $14 to $56Professionalmedian $54 · 10th to 90th $35 to $54
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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $46.77 Typical High $46.77 | Professional | None (both parts) | $34.67 | $46.77 | $46.77 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $25.12 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $25.12 | $33.11 | $33.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Facility | None | $83.18 | $83.18 | $100.00 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | None (both parts) | $50.12 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Facility | None | $40.74 | $40.74 | $50.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None (both parts) | $34.67 | $34.67 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $50.12 Typical High $53.70 | Professional | None | $21.38 | $50.12 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $34.67 Typical High $56.23 | Facility | None | $13.80 | $34.67 | $56.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $19.95 Median $43.65 Typical High $77.62 | Professional | None (both parts) | $19.95 | $43.65 | $77.62 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $38.90 Typical High $56.23 | Professional | None (both parts) | $23.44 | $38.90 | $56.23 |
16 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 55 · Aftercare only Typical Low $5.37 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.37 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.63 | $4.68 | $4.68 |
Aetna Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | RR · Rental | $9.12 | $9.12 | $10.00 |
Cigna Setting Facility Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | RR · Rental | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $20.89 Typical High $30.90 | Professional | 26 · Professional part | $7.94 | $20.89 | $30.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $30.20 Median $64.57 Typical High $117.49 | Professional | 50 · Both sides | $30.20 | $64.57 | $117.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.00 Median $21.88 Typical High $38.90 | Professional | 51 · Multiple procedures | $10.00 | $21.88 | $38.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.98 Median $8.71 Typical High $15.49 | Professional | 80 · Assistant surgeon | $3.98 | $8.71 | $15.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.82 Median $6.03 Typical High $10.96 | Professional | 81 · Minimal assistant surgeon | $2.82 | $6.03 | $10.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.82 Median $6.03 Typical High $10.96 | Professional | 82 · Assistant surgeon, no resident | $2.82 | $6.03 | $10.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.82 Median $6.03 Typical High $10.96 | Professional | AS · PA/NP assist | $2.82 | $6.03 | $10.96 |
Medcost Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | RR · Rental | $2.04 | $2.04 | $2.04 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $7.08 Median $10.23 Typical High $10.23 | Professional | SH · Second concurrent infusion | $7.08 | $10.23 | $10.23 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $7.08 Median $10.23 Typical High $10.23 | Professional | SJ · Third+ concurrent infusion | $7.08 | $10.23 | $10.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $12.02 Median $31.62 Typical High $46.77 | Professional | TC · Technical part | $12.02 | $31.62 | $46.77 |
Where North Carolina sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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· 15th of 51
$53.70
HI $79.43WY $12.02
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.