How much rates vary
Facilitymedian $55 · 10th to 90th $25 to $66Professionalmedian $59 · 10th to 90th $38 to $66
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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $38.02 | $66.07 | $66.07 |
BCBS North Carolina Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $50.12 Median $58.88 Typical High $61.66 | Professional | None (both parts) | $50.12 | $58.88 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $39.81 | $54.95 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $51.29 | Professional | None | $36.31 | $38.90 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $74.13 | Facility | None | $24.55 | $41.69 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $42.66 Median $53.70 Typical High $91.20 | Professional | None (both parts) | $42.66 | $53.70 | $91.20 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $38.02 Typical High $51.29 | Professional | None (both parts) | $29.51 | $38.02 | $51.29 |
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 $19.05 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $19.05 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $7.59 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $5.75 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.80 | $6.61 | $6.61 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $22.91 Typical High $51.29 | Professional | 26 · Professional part | $21.38 | $22.91 | $51.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $81.28 Typical High $257.04 | Professional | 50 · Both sides | $64.57 | $81.28 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $26.92 Typical High $85.11 | Professional | 51 · Multiple procedures | $21.38 | $26.92 | $85.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $10.72 Typical High $34.67 | Professional | 80 · Assistant surgeon | $8.51 | $10.72 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.03 Median $7.59 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $6.03 | $7.59 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.03 Median $7.59 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $6.03 | $7.59 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.03 Median $7.59 Typical High $23.99 | Professional | AS · PA/NP assist | $6.03 | $7.59 | $23.99 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | SH · Second concurrent infusion | $21.38 | $21.38 | $21.38 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | SJ · Third+ concurrent infusion | $21.38 | $21.38 | $21.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $34.67 Typical High $77.62 | Professional | TC · Technical part | $32.36 | $34.67 | $77.62 |
Where North Carolina sits
The same service costs 3.5 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· 21st of 51
$58.88
HI $141WV $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.