How much rates vary
Facilitymedian $33 · 10th to 90th $16 to $50Professionalmedian $44 · 10th to 90th $26 to $50
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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $28.18 | $50.12 | $50.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $56.23 | Facility | None | $46.77 | $46.77 | $56.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $37.15 Median $43.65 Typical High $46.77 | Professional | None (both parts) | $37.15 | $43.65 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $23.99 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $23.99 | $33.11 | $33.11 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $37.15 | Professional | None | $26.30 | $28.84 | $37.15 |
Medcost Setting Facility Modifier None Typical Low $16.22 Median $50.12 Typical High $57.54 | Facility | None | $16.22 | $50.12 | $57.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.11 Median $41.69 Typical High $69.18 | Professional | None (both parts) | $33.11 | $41.69 | $69.18 |
United Setting Professional Modifier None (both parts) Typical Low $19.50 Median $28.18 Typical High $38.02 | Professional | None (both parts) | $19.50 | $28.18 | $38.02 |
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 $14.13 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $14.13 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $5.62 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $4.27 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.82 | $5.01 | $5.01 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $16.98 Median $16.98 Typical High $38.02 | Professional | 26 · Professional part | $16.98 | $16.98 | $38.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $63.10 Typical High $194.98 | Professional | 50 · Both sides | $48.98 | $63.10 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $20.89 Typical High $64.57 | Professional | 51 · Multiple procedures | $16.60 | $20.89 | $64.57 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $8.32 Typical High $25.70 | Professional | 80 · Assistant surgeon | $6.61 | $8.32 | $25.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.57 Median $5.89 Typical High $18.20 | Professional | 81 · Minimal assistant surgeon | $4.57 | $5.89 | $18.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.57 Median $5.89 Typical High $18.20 | Professional | 82 · Assistant surgeon, no resident | $4.57 | $5.89 | $18.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.57 Median $5.89 Typical High $18.20 | Professional | AS · PA/NP assist | $4.57 | $5.89 | $18.20 |
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 $25.12 Median $25.70 Typical High $57.54 | Professional | TC · Technical part | $25.12 | $25.70 | $57.54 |
Where North Carolina sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 15th of 51
$43.65
MT $60.26KS $23.44
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.