How much rates vary
Facilitymedian $58 · 10th to 90th $29 to $81Professionalmedian $71 · 10th to 90th $44 to $81
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 $47.86 Median $81.28 Typical High $81.28 | Facility | None | $47.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $81.28 Typical High $93.33 | Professional | None (both parts) | $45.71 | $81.28 | $93.33 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $30.90 Median $70.79 Typical High $83.18 | Professional | None (both parts) | $30.90 | $70.79 | $83.18 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | None (both parts) | $60.26 | $70.79 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $57.54 Typical High $57.54 | Professional | None (both parts) | $42.66 | $57.54 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $70.79 | Professional | None | $56.23 | $60.26 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $50.12 Typical High $89.13 | Facility | None | $28.84 | $50.12 | $89.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $64.57 Typical High $112.20 | Professional | None (both parts) | $52.48 | $64.57 | $112.20 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $34.67 Median $45.71 Typical High $64.57 | Professional | None (both parts) | $34.67 | $45.71 | $64.57 |
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 $25.12 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $25.12 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $10.00 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.01 | $8.13 | $8.13 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $27.54 Typical High $61.66 | Professional | 26 · Professional part | $21.38 | $27.54 | $61.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $97.72 Typical High $316.23 | Professional | 50 · Both sides | $77.62 | $97.72 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.70 Median $32.36 Typical High $104.71 | Professional | 51 · Multiple procedures | $25.70 | $32.36 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $12.88 Typical High $41.69 | Professional | 80 · Assistant surgeon | $10.47 | $12.88 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.24 Median $9.12 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $7.24 | $9.12 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.24 Median $9.12 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $7.24 | $9.12 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.24 Median $9.12 Typical High $29.51 | Professional | AS · PA/NP assist | $7.24 | $9.12 | $29.51 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SH · Second concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SJ · Third+ concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $41.69 Typical High $93.33 | Professional | TC · Technical part | $31.62 | $41.69 | $93.33 |
Where North Carolina sits
The same service costs 2.6 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· 19th of 51
$70.79
HI $117DE $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.