How much rates vary
Facilitymedian $63 · 10th to 90th $31 to $83Professionalmedian $72 · 10th to 90th $46 to $83
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $46.77 | $83.18 | $83.18 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $58.88 Median $85.11 Typical High $100.00 | Professional | None (both parts) | $58.88 | $85.11 | $100.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Facility | None | $79.43 | $79.43 | $95.50 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $56.23 Median $72.44 Typical High $97.72 | Professional | None (both parts) | $56.23 | $72.44 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $63.10 | Facility | None | $56.23 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $63.10 Typical High $63.10 | Professional | None (both parts) | $45.71 | $63.10 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $64.57 | Professional | None | $51.29 | $54.95 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $52.48 Typical High $91.20 | Facility | None | $30.90 | $52.48 | $91.20 |
Medcost Setting Professional Modifier None (both parts) Typical Low $53.70 Median $67.61 Typical High $114.82 | Professional | None (both parts) | $53.70 | $67.61 | $114.82 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Facility | None | $60.26 | $60.26 | $63.10 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $47.86 Typical High $66.07 | Professional | None (both parts) | $36.31 | $47.86 | $66.07 |
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 $23.99 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $23.99 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $9.55 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $7.24 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.79 | $8.32 | $8.32 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $28.84 Typical High $64.57 | Professional | 26 · Professional part | $26.92 | $28.84 | $64.57 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $102.33 Typical High $323.59 | Professional | 50 · Both sides | $81.28 | $102.33 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | 51 · Multiple procedures | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $43.65 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $43.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $9.55 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $7.59 | $9.55 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $9.55 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $9.55 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $9.55 Typical High $30.20 | Professional | AS · PA/NP assist | $7.59 | $9.55 | $30.20 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | SH · Second concurrent infusion | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | SJ · Third+ concurrent infusion | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $43.65 Typical High $95.50 | Professional | TC · Technical part | $40.74 | $43.65 | $95.50 |
Where North Carolina sits
The same service costs 3.8 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· 21st of 51
$72.44
HI $174FL $45.71
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.