How much rates vary
Facilitymedian $30 · 10th to 90th $17 to $33Professionalmedian $25 · 10th to 90th $21 to $35
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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $20.42 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $20.42 | $33.11 | $33.11 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None (both parts) | $28.84 | $28.84 | $28.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $24.55 Typical High $32.36 | Professional | None (both parts) | $23.44 | $24.55 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $21.88 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $21.88 | $30.20 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $33.11 Typical High $39.81 | Facility | None | $17.38 | $33.11 | $39.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.11 Median $40.74 Typical High $50.12 | Professional | None (both parts) | $33.11 | $40.74 | $50.12 |
United Setting Professional Modifier None (both parts) Typical Low $13.80 Median $20.89 Typical High $30.90 | Professional | None (both parts) | $13.80 | $20.89 | $30.90 |
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 $10.00 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $10.00 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $4.07 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $3.02 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.04 | $3.31 | $3.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $13.18 Median $16.22 Typical High $25.12 | Professional | 26 · Professional part | $13.18 | $16.22 | $25.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $60.26 Typical High $120.23 | Professional | 50 · Both sides | $48.98 | $60.26 | $120.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $20.42 Typical High $39.81 | Professional | 51 · Multiple procedures | $16.60 | $20.42 | $39.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $8.13 Typical High $15.85 | Professional | 80 · Assistant surgeon | $6.61 | $8.13 | $15.85 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.57 Median $5.62 Typical High $11.22 | Professional | 81 · Minimal assistant surgeon | $4.57 | $5.62 | $11.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.57 Median $5.62 Typical High $11.22 | Professional | 82 · Assistant surgeon, no resident | $4.57 | $5.62 | $11.22 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.57 Median $5.62 Typical High $11.22 | Professional | AS · PA/NP assist | $4.57 | $5.62 | $11.22 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | SH · Second concurrent infusion | $20.42 | $20.42 | $20.42 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | SJ · Third+ concurrent infusion | $20.42 | $20.42 | $20.42 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $19.95 Median $24.55 Typical High $35.48 | Professional | TC · Technical part | $19.95 | $24.55 | $35.48 |
Where North Carolina sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 37th of 51
$24.55
KS $135HI $20.89
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.