How much rates vary
Facilitymedian $39 · 10th to 90th $19 to $51Professionalmedian $45 · 10th to 90th $28 to $51
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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.84 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $28.84 | $51.29 | $51.29 |
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 Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Facility | None | $47.86 | $47.86 | $57.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $33.88 Median $44.67 Typical High $58.88 | Professional | None (both parts) | $33.88 | $44.67 | $58.88 |
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 $28.18 Median $38.90 Typical High $38.90 | Professional | None (both parts) | $28.18 | $38.90 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | None | $36.31 | $38.90 | $38.90 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $31.62 Typical High $56.23 | Facility | None | $18.62 | $31.62 | $56.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.11 Median $40.74 Typical High $70.79 | Professional | None (both parts) | $33.11 | $40.74 | $70.79 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
United Setting Professional Modifier None (both parts) Typical Low $22.39 Median $28.84 Typical High $40.74 | Professional | None (both parts) | $22.39 | $28.84 | $40.74 |
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 $14.45 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $14.45 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $5.75 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $4.37 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.88 | $5.13 | $5.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $16.22 Median $17.38 Typical High $38.90 | Professional | 26 · Professional part | $16.22 | $17.38 | $38.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $61.66 Typical High $199.53 | Professional | 50 · Both sides | $48.98 | $61.66 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $20.42 Typical High $66.07 | Professional | 51 · Multiple procedures | $16.60 | $20.42 | $66.07 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $8.13 Typical High $26.30 | Professional | 80 · Assistant surgeon | $6.61 | $8.13 | $26.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.57 Median $5.75 Typical High $18.62 | Professional | 81 · Minimal assistant surgeon | $4.57 | $5.75 | $18.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.57 Median $5.75 Typical High $18.62 | Professional | 82 · Assistant surgeon, no resident | $4.57 | $5.75 | $18.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.57 Median $5.75 Typical High $18.62 | Professional | AS · PA/NP assist | $4.57 | $5.75 | $18.62 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | SH · Second concurrent infusion | $16.60 | $16.60 | $16.60 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | SJ · Third+ concurrent infusion | $16.60 | $16.60 | $16.60 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $26.30 Typical High $58.88 | Professional | TC · Technical part | $24.55 | $26.30 | $58.88 |
Where North Carolina sits
The same service costs 3.0 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· 18th of 51
$44.67
HI $83.18DE $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.