How much rates vary
Facilitymedian $54 · 10th to 90th $25 to $71Professionalmedian $62 · 10th to 90th $38 to $71
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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $39.81 | $70.79 | $70.79 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None (both parts) | $74.13 | $74.13 | $74.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $79.43 | Facility | None | $67.61 | $67.61 | $79.43 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $46.77 Median $61.66 Typical High $83.18 | Professional | None (both parts) | $46.77 | $61.66 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | None (both parts) | $39.81 | $53.70 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $51.29 | Professional | None | $35.48 | $38.02 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $44.67 Typical High $77.62 | Facility | None | $24.55 | $44.67 | $77.62 |
Medcost Setting Professional Modifier None (both parts) Typical Low $45.71 Median $57.54 Typical High $97.72 | Professional | None (both parts) | $45.71 | $57.54 | $97.72 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Facility | None | $47.86 | $47.86 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $39.81 Typical High $53.70 | Professional | None (both parts) | $29.51 | $39.81 | $53.70 |
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 $19.95 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $19.95 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $7.94 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $6.03 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.98 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $24.55 Typical High $54.95 | Professional | 26 · Professional part | $22.91 | $24.55 | $54.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $69.18 Median $85.11 Typical High $275.42 | Professional | 50 · Both sides | $69.18 | $85.11 | $275.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.91 Median $28.18 Typical High $91.20 | Professional | 51 · Multiple procedures | $22.91 | $28.18 | $91.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.12 Median $11.48 Typical High $36.31 | Professional | 80 · Assistant surgeon | $9.12 | $11.48 | $36.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.46 Median $7.94 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $6.46 | $7.94 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.46 Median $7.94 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $6.46 | $7.94 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.46 Median $7.94 Typical High $25.70 | Professional | AS · PA/NP assist | $6.46 | $7.94 | $25.70 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | SH · Second concurrent infusion | $22.91 | $22.91 | $22.91 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | SJ · Third+ concurrent infusion | $22.91 | $22.91 | $22.91 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $36.31 Typical High $81.28 | Professional | TC · Technical part | $33.88 | $36.31 | $81.28 |
Where North Carolina sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 16th of 51
$61.66
HI $123WV $39.81
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.