How much rates vary
Facilitymedian $39 · 10th to 90th $17 to $47Professionalmedian $41 · 10th to 90th $27 to $47
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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $26.30 Median $46.77 Typical High $46.77 | Professional | None (both parts) | $26.30 | $46.77 | $46.77 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $38.90 Median $40.74 Typical High $54.95 | Professional | None (both parts) | $38.90 | $40.74 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $28.84 Median $38.90 Typical High $38.90 | Professional | None (both parts) | $28.84 | $38.90 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | None | $33.11 | $35.48 | $35.48 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $29.51 Typical High $51.29 | Facility | None | $17.38 | $29.51 | $51.29 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.20 Median $38.02 Typical High $64.57 | Professional | None (both parts) | $30.20 | $38.02 | $64.57 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | None | $35.48 | $35.48 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $20.42 Median $26.92 Typical High $36.31 | Professional | None (both parts) | $20.42 | $26.92 | $36.31 |
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 $13.18 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $13.18 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $5.25 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $3.98 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.63 | $4.68 | $4.68 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.14 Median $16.22 Typical High $36.31 | Professional | 26 · Professional part | $15.14 | $16.22 | $36.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $44.67 Median $57.54 Typical High $181.97 | Professional | 50 · Both sides | $44.67 | $57.54 | $181.97 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $19.05 Typical High $60.26 | Professional | 51 · Multiple procedures | $15.14 | $19.05 | $60.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.03 Median $7.59 Typical High $23.99 | Professional | 80 · Assistant surgeon | $6.03 | $7.59 | $23.99 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.17 Median $5.37 Typical High $16.98 | Professional | 81 · Minimal assistant surgeon | $4.17 | $5.37 | $16.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.17 Median $5.37 Typical High $16.98 | Professional | 82 · Assistant surgeon, no resident | $4.17 | $5.37 | $16.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.17 Median $5.37 Typical High $16.98 | Professional | AS · PA/NP assist | $4.17 | $5.37 | $16.98 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | SH · Second concurrent infusion | $15.14 | $15.14 | $15.14 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | SJ · Third+ concurrent infusion | $15.14 | $15.14 | $15.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $22.91 Median $23.99 Typical High $53.70 | Professional | TC · Technical part | $22.91 | $23.99 | $53.70 |
Where North Carolina sits
The same service costs 4.7 times more in Hawaii than in Florida. 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· 20th of 51
$40.74
HI $132FL $28.18
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.