How much rates vary
Facilitymedian $28 · 10th to 90th $25 to $30Professionalmedian $28 · 10th to 90th $18 to $35
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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $21.88 Median $27.54 Typical High $27.54 | Professional | None (both parts) | $21.88 | $27.54 | $27.54 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1.51 Median $2.40 Typical High $2.40 | Professional | RR · Rental | $1.51 | $2.40 | $2.40 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None (both parts) | $19.95 | $19.95 | $19.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | None | $32.36 | $32.36 | $38.90 |
BCBS North Carolina Setting Professional Modifier RR · Rental Typical Low $2.24 Median $2.34 Typical High $2.34 | Professional | RR · Rental | $2.24 | $2.34 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $29.51 | Facility | None | $25.12 | $25.12 | $29.51 |
Cigna Setting Facility Modifier RR · Rental Typical Low $2.95 Median $25.12 Typical High $25.12 | Facility | RR · Rental | $2.95 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $21.38 Median $21.38 Typical High $26.92 | Professional | None (both parts) | $21.38 | $21.38 | $26.92 |
Cigna Setting Professional Modifier RR · Rental Typical Low $2.14 Median $2.14 Typical High $2.51 | Professional | RR · Rental | $2.14 | $2.14 | $2.51 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | None | $22.91 | $22.91 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $28.18 Typical High $40.74 | Facility | None | $27.54 | $28.18 | $40.74 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.30 Median $29.51 Typical High $69.18 | Professional | None (both parts) | $26.30 | $29.51 | $69.18 |
Medcost Setting Professional Modifier RR · Rental Typical Low $2.00 Median $2.40 Typical High $25.12 | Professional | RR · Rental | $2.00 | $2.40 | $25.12 |
United Setting Professional Modifier None (both parts) Typical Low $14.13 Median $19.50 Typical High $23.44 | Professional | None (both parts) | $14.13 | $19.50 | $23.44 |
United Setting Professional Modifier RR · Rental Typical Low $1.23 Median $1.62 Typical High $2.51 | Professional | RR · Rental | $1.23 | $1.62 | $2.51 |
14 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 MS · Maintenance fee Typical Low $2.24 Median $2.40 Typical High $2.40 | Professional | MS · Maintenance fee | $2.24 | $2.40 | $2.40 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $16.98 Median $20.89 Typical High $20.89 | Professional | UE · Used equipment | $16.98 | $20.89 | $20.89 |
Cigna Setting Professional Modifier UE · Used equipment Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | UE · Used equipment | $16.22 | $16.22 | $16.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $12.88 Typical High $13.80 | Professional | 26 · Professional part | $12.02 | $12.88 | $13.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $39.81 Median $44.67 Typical High $147.91 | Professional | 50 · Both sides | $39.81 | $44.67 | $147.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.18 Median $14.79 Typical High $50.12 | Professional | 51 · Multiple procedures | $13.18 | $14.79 | $50.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.25 Median $5.89 Typical High $19.95 | Professional | 80 · Assistant surgeon | $5.25 | $5.89 | $19.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.72 Median $4.17 Typical High $13.80 | Professional | 81 · Minimal assistant surgeon | $3.72 | $4.17 | $13.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.72 Median $4.17 Typical High $13.80 | Professional | 82 · Assistant surgeon, no resident | $3.72 | $4.17 | $13.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.72 Median $4.17 Typical High $13.80 | Professional | AS · PA/NP assist | $3.72 | $4.17 | $13.80 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | SH · Second concurrent infusion | $114.82 | $114.82 | $114.82 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | SJ · Third+ concurrent infusion | $114.82 | $114.82 | $114.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $17.78 Median $19.05 Typical High $20.89 | Professional | TC · Technical part | $17.78 | $19.05 | $20.89 |
United Setting Professional Modifier UE · Used equipment Typical Low $9.33 Median $12.02 Typical High $23.44 | Professional | UE · Used equipment | $9.33 | $12.02 | $23.44 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Rhode Island. 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· 24th of 51
$27.54
HI $42.66RI $16.22
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.