How much rates vary
Facilitymedian $56 · 10th to 90th $56 to $115Professionalmedian $85 · 10th to 90th $65 to $126
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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $67.61 Median $114.82 Typical High $114.82 | Professional | None (both parts) | $67.61 | $114.82 | $114.82 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $85.11 Typical High $112.20 | Professional | None (both parts) | $81.28 | $85.11 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $56.23 Typical High $56.23 | Professional | None (both parts) | $41.69 | $56.23 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $114.82 Typical High $138.04 | Facility | None | $60.26 | $114.82 | $138.04 |
Medcost Setting Professional Modifier None (both parts) Typical Low $114.82 Median $204.17 Typical High $234.42 | Professional | None (both parts) | $114.82 | $204.17 | $234.42 |
United Setting Professional Modifier None (both parts) Typical Low $48.98 Median $72.44 Typical High $107.15 | Professional | None (both parts) | $48.98 | $72.44 | $107.15 |
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 $34.67 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $34.67 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $14.13 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $10.47 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.08 | $11.48 | $11.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $75.86 Typical High $93.33 | Professional | 26 · Professional part | $46.77 | $75.86 | $93.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $309.03 Typical High $416.87 | Professional | 50 · Both sides | $173.78 | $309.03 | $416.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $102.33 Typical High $138.04 | Professional | 51 · Multiple procedures | $57.54 | $102.33 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $40.74 Typical High $54.95 | Professional | 80 · Assistant surgeon | $22.91 | $40.74 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $28.84 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $16.22 | $28.84 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $28.84 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $28.84 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $28.84 Typical High $38.90 | Professional | AS · PA/NP assist | $16.22 | $28.84 | $38.90 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | SH · Second concurrent infusion | $102.33 | $102.33 | $102.33 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | SJ · Third+ concurrent infusion | $102.33 | $102.33 | $102.33 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $69.18 Median $114.82 Typical High $141.25 | Professional | TC · Technical part | $69.18 | $114.82 | $141.25 |
Where North Carolina sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 30th of 51
$85.11
ND $295DE $60.26
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.