How much rates vary
Facilitymedian $89 · 10th to 90th $35 to $129Professionalmedian $112 · 10th to 90th $66 to $129
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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $128.82 Typical High $128.82 | Professional | None (both parts) | $66.07 | $128.82 | $128.82 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None (both parts) | $95.50 | $95.50 | $95.50 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $95.50 Median $112.20 Typical High $120.23 | Professional | None (both parts) | $95.50 | $112.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $89.13 | Facility | None | $85.11 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $89.13 Typical High $91.20 | Professional | None (both parts) | $64.57 | $89.13 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $74.13 | Professional | None | $56.23 | $60.26 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $79.43 Typical High $128.82 | Facility | None | $35.48 | $79.43 | $128.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $81.28 Median $102.33 Typical High $177.83 | Professional | None (both parts) | $81.28 | $102.33 | $177.83 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Facility | None | $72.44 | $72.44 | $75.86 |
United Setting Professional Modifier None (both parts) Typical Low $48.98 Median $69.18 Typical High $85.11 | Professional | None (both parts) | $48.98 | $69.18 | $85.11 |
15 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 $33.88 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $33.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $13.49 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $10.00 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.76 | $12.88 | $12.88 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $43.65 Typical High $97.72 | Professional | 26 · Professional part | $33.11 | $43.65 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $154.88 Typical High $501.19 | Professional | 50 · Both sides | $123.03 | $154.88 | $501.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $51.29 Typical High $165.96 | Professional | 51 · Multiple procedures | $40.74 | $51.29 | $165.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.22 Median $20.42 Typical High $66.07 | Professional | 80 · Assistant surgeon | $16.22 | $20.42 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.48 Median $14.45 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $11.48 | $14.45 | $46.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.48 Median $14.45 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $11.48 | $14.45 | $46.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.48 Median $14.45 Typical High $46.77 | Professional | AS · PA/NP assist | $11.48 | $14.45 | $46.77 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | SH · Second concurrent infusion | $40.74 | $40.74 | $40.74 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | SJ · Third+ concurrent infusion | $40.74 | $40.74 | $40.74 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $66.07 Typical High $147.91 | Professional | TC · Technical part | $50.12 | $66.07 | $147.91 |
Where North Carolina sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 11th of 51
$112
HI $166DC $58.88
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.