How much rates vary
Facilitymedian $91 · 10th to 90th $45 to $162Professionalmedian $141 · 10th to 90th $83 to $162
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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $79.43 | $162.18 | $162.18 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $138.04 Median $141.25 Typical High $190.55 | Professional | None (both parts) | $138.04 | $141.25 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | None (both parts) | $66.07 | $91.20 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $102.33 | Professional | None | $77.62 | $83.18 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $102.33 Typical High $169.82 | Facility | None | $44.67 | $102.33 | $169.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $104.71 Median $131.83 Typical High $223.87 | Professional | None (both parts) | $104.71 | $131.83 | $223.87 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None (both parts) Typical Low $61.66 Median $89.13 Typical High $109.65 | Professional | None (both parts) | $61.66 | $89.13 | $109.65 |
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 $42.66 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $42.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $16.98 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $12.88 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.51 | $16.22 | $16.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $52.48 Median $56.23 Typical High $125.89 | Professional | 26 · Professional part | $52.48 | $56.23 | $125.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $194.98 Typical High $630.96 | Professional | 50 · Both sides | $158.49 | $194.98 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $66.07 Typical High $208.93 | Professional | 51 · Multiple procedures | $52.48 | $66.07 | $208.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.89 Median $26.30 Typical High $83.18 | Professional | 80 · Assistant surgeon | $20.89 | $26.30 | $83.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.79 Median $18.20 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $14.79 | $18.20 | $58.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.79 Median $18.20 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $14.79 | $18.20 | $58.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.79 Median $18.20 Typical High $58.88 | Professional | AS · PA/NP assist | $14.79 | $18.20 | $58.88 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | SH · Second concurrent infusion | $52.48 | $52.48 | $52.48 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | SJ · Third+ concurrent infusion | $52.48 | $52.48 | $52.48 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $83.18 Typical High $186.21 | Professional | TC · Technical part | $79.43 | $83.18 | $186.21 |
Where North Carolina sits
The same service costs 2.5 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· 6th of 51
$141
MT $162DE $66.07
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.