How much rates vary
Facilitymedian $62 · 10th to 90th $26 to $95Professionalmedian $83 · 10th to 90th $49 to $95
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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $95.50 Typical High $95.50 | Professional | None (both parts) | $51.29 | $95.50 | $95.50 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $63.10 Median $83.18 Typical High $109.65 | Professional | None (both parts) | $63.10 | $83.18 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $61.66 Typical High $63.10 | Professional | None (both parts) | $44.67 | $61.66 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $64.57 | Professional | None | $42.66 | $45.71 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $26.30 Median $58.88 Typical High $95.50 | Facility | None | $26.30 | $58.88 | $95.50 |
Medcost Setting Professional Modifier None (both parts) Typical Low $61.66 Median $77.62 Typical High $131.83 | Professional | None (both parts) | $61.66 | $77.62 | $131.83 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $45.71 | Facility | None | $41.69 | $41.69 | $45.71 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $51.29 Typical High $63.10 | Professional | None (both parts) | $36.31 | $51.29 | $63.10 |
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 $25.70 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $25.70 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $10.23 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $7.76 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.13 | $9.55 | $9.55 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.90 Median $32.36 Typical High $72.44 | Professional | 26 · Professional part | $30.90 | $32.36 | $72.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $114.82 Typical High $371.54 | Professional | 50 · Both sides | $91.20 | $114.82 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $38.90 Typical High $123.03 | Professional | 51 · Multiple procedures | $30.20 | $38.90 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $15.49 Typical High $48.98 | Professional | 80 · Assistant surgeon | $12.30 | $15.49 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.51 Median $10.72 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $8.51 | $10.72 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.51 Median $10.72 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $8.51 | $10.72 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.51 Median $10.72 Typical High $34.67 | Professional | AS · PA/NP assist | $8.51 | $10.72 | $34.67 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | SH · Second concurrent infusion | $30.20 | $30.20 | $30.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | SJ · Third+ concurrent infusion | $30.20 | $30.20 | $30.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $45.71 Median $48.98 Typical High $109.65 | Professional | TC · Technical part | $45.71 | $48.98 | $109.65 |
Where North Carolina sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 6th of 51
$83.18
HI $112AZ $44.67
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.