How much rates vary
Facilitymedian $36 · 10th to 90th $22 to $60Professionalmedian $52 · 10th to 90th $32 to $60
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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $60.26 Typical High $60.26 | Professional | None (both parts) | $37.15 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $52.48 | $52.48 | $52.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Facility | None | $56.23 | $56.23 | $67.61 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $44.67 Median $52.48 Typical High $56.23 | Professional | None (both parts) | $44.67 | $52.48 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $26.92 Median $36.31 Typical High $36.31 | Professional | None (both parts) | $26.92 | $36.31 | $36.31 |
Medcost Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $51.29 | Professional | None | $31.62 | $33.88 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $37.15 Typical High $66.07 | Facility | None | $21.88 | $37.15 | $66.07 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.02 Median $47.86 Typical High $81.28 | Professional | None (both parts) | $38.02 | $47.86 | $81.28 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None (both parts) Typical Low $25.70 Median $33.88 Typical High $45.71 | Professional | None (both parts) | $25.70 | $33.88 | $45.71 |
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 $18.62 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $18.62 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $7.41 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $5.62 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.72 | $6.03 | $6.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $20.42 Typical High $45.71 | Professional | 26 · Professional part | $19.05 | $20.42 | $45.71 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $72.44 Typical High $229.09 | Professional | 50 · Both sides | $57.54 | $72.44 | $229.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $23.99 Typical High $77.62 | Professional | 51 · Multiple procedures | $19.05 | $23.99 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $9.55 Typical High $30.90 | Professional | 80 · Assistant surgeon | $7.59 | $9.55 | $30.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $6.76 Typical High $21.38 | Professional | 81 · Minimal assistant surgeon | $5.37 | $6.76 | $21.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $6.76 Typical High $21.38 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $6.76 | $21.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $6.76 Typical High $21.38 | Professional | AS · PA/NP assist | $5.37 | $6.76 | $21.38 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | SH · Second concurrent infusion | $19.05 | $19.05 | $19.05 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | SJ · Third+ concurrent infusion | $19.05 | $19.05 | $19.05 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $30.90 Typical High $69.18 | Professional | TC · Technical part | $28.84 | $30.90 | $69.18 |
Where North Carolina sits
The same service costs 2.9 times more in Hawaii than in Delaware. 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· 18th of 51
$52.48
HI $91.20DE $31.62
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.