How much rates vary
Facilitymedian $52 · 10th to 90th $19 to $63Professionalmedian $59 · 10th to 90th $45 to $74
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $63.10 Typical High $63.10 | Professional | None (both parts) | $34.67 | $63.10 | $63.10 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $85.11 | $117.49 | $117.49 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $57.54 Median $58.88 Typical High $74.13 | Professional | None (both parts) | $57.54 | $58.88 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $44.67 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $63.10 Typical High $74.13 | Facility | None | $19.05 | $63.10 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | None (both parts) | $74.13 | $74.13 | $97.72 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $44.67 Typical High $66.07 | Professional | None (both parts) | $29.51 | $44.67 | $66.07 |
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 52 · Reduced service Typical Low $17.78 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $17.78 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $7.08 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $5.37 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.55 | $6.31 | $6.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $29.51 Typical High $46.77 | Professional | 26 · Professional part | $29.51 | $29.51 | $46.77 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $109.65 Typical High $229.09 | Professional | 50 · Both sides | $109.65 | $109.65 | $229.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $37.15 Typical High $75.86 | Professional | 51 · Multiple procedures | $37.15 | $37.15 | $75.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $14.79 Typical High $30.20 | Professional | 80 · Assistant surgeon | $14.79 | $14.79 | $30.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $10.23 Typical High $21.38 | Professional | 81 · Minimal assistant surgeon | $10.23 | $10.23 | $21.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $10.23 Typical High $21.38 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $10.23 | $21.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $10.23 Typical High $21.38 | Professional | AS · PA/NP assist | $10.23 | $10.23 | $21.38 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | SH · Second concurrent infusion | $37.15 | $37.15 | $37.15 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | SJ · Third+ concurrent infusion | $37.15 | $37.15 | $37.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | TC · Technical part | $44.67 | $44.67 | $70.79 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 10th of 51
$58.88
HI $93.33UT $36.31
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.