How much rates vary
Facilitymedian $41 · 10th to 90th $20 to $69Professionalmedian $60 · 10th to 90th $35 to $69
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $37.15 | $69.18 | $69.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Facility | None | $66.07 | $66.07 | $79.43 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $46.77 Median $60.26 Typical High $81.28 | Professional | None (both parts) | $46.77 | $60.26 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $40.74 Typical High $43.65 | Professional | None (both parts) | $29.51 | $40.74 | $43.65 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $50.12 | Professional | None | $30.20 | $32.36 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $19.95 Median $43.65 Typical High $69.18 | Facility | None | $19.95 | $43.65 | $69.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $44.67 Median $56.23 Typical High $95.50 | Professional | None (both parts) | $44.67 | $56.23 | $95.50 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Facility | None | $36.31 | $36.31 | $40.74 |
United Setting Professional Modifier None (both parts) Typical Low $26.30 Median $38.02 Typical High $47.86 | Professional | None (both parts) | $26.30 | $38.02 | $47.86 |
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 $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $18.62 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $7.41 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $5.50 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.72 | $6.92 | $6.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $22.39 Median $23.99 Typical High $53.70 | Professional | 26 · Professional part | $22.39 | $23.99 | $53.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $83.18 Typical High $269.15 | Professional | 50 · Both sides | $67.61 | $83.18 | $269.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $28.18 Typical High $89.13 | Professional | 51 · Multiple procedures | $22.39 | $28.18 | $89.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.91 Median $11.22 Typical High $36.31 | Professional | 80 · Assistant surgeon | $8.91 | $11.22 | $36.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $7.76 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $6.31 | $7.76 | $25.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $7.76 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $7.76 | $25.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.31 Median $7.76 Typical High $25.12 | Professional | AS · PA/NP assist | $6.31 | $7.76 | $25.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | SH · Second concurrent infusion | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | SJ · Third+ concurrent infusion | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $35.48 Typical High $79.43 | Professional | TC · Technical part | $33.88 | $35.48 | $79.43 |
Where North Carolina sits
The same service costs 2.7 times more in Montana 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· 14th of 51
$60.26
MT $83.18DE $30.90
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.