How much rates vary
Facilitymedian $105 · 10th to 90th $41 to $112Professionalmedian $98 · 10th to 90th $60 to $112
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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $66.07 | $112.20 | $112.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $125.89 | Facility | None | $104.71 | $104.71 | $125.89 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $74.13 Median $97.72 Typical High $128.82 | Professional | None (both parts) | $74.13 | $97.72 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $75.86 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $75.86 | $104.71 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $107.15 | Professional | None | $79.43 | $85.11 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $123.03 | Facility | None | $40.74 | $69.18 | $123.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $72.44 Median $89.13 Typical High $151.36 | Professional | None (both parts) | $72.44 | $89.13 | $151.36 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
United Setting Professional Modifier None (both parts) Typical Low $48.98 Median $63.10 Typical High $89.13 | Professional | None (both parts) | $48.98 | $63.10 | $89.13 |
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 $38.02 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $38.02 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $15.14 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $11.48 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.59 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $38.02 Typical High $85.11 | Professional | 26 · Professional part | $36.31 | $38.02 | $85.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $134.90 Typical High $426.58 | Professional | 50 · Both sides | $107.15 | $134.90 | $426.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $44.67 Typical High $144.54 | Professional | 51 · Multiple procedures | $36.31 | $44.67 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $18.20 Typical High $57.54 | Professional | 80 · Assistant surgeon | $14.45 | $18.20 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $12.59 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $10.00 | $12.59 | $39.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $12.59 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $12.59 | $39.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $12.59 Typical High $39.81 | Professional | AS · PA/NP assist | $10.00 | $12.59 | $39.81 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | SH · Second concurrent infusion | $36.31 | $36.31 | $36.31 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | SJ · Third+ concurrent infusion | $36.31 | $36.31 | $36.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $53.70 Median $57.54 Typical High $128.82 | Professional | TC · Technical part | $53.70 | $57.54 | $128.82 |
Where North Carolina sits
The same service costs 3.0 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· 19th of 51
$97.72
HI $204FL $67.61
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.