How much rates vary
Facilitymedian $55 · 10th to 90th $15 to $55Professionalmedian $21 · 10th to 90th $18 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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $16.98 Median $28.84 Typical High $28.84 | Professional | None (both parts) | $16.98 | $28.84 | $28.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.89 Typical High $28.18 | Professional | None (both parts) | $20.42 | $20.89 | $28.18 |
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 Facility Modifier None Typical Low $15.14 Median $28.84 Typical High $34.67 | Facility | None | $15.14 | $28.84 | $34.67 |
Medcost Setting Professional Modifier None (both parts) Typical Low $28.84 Median $34.67 Typical High $69.18 | Professional | None (both parts) | $28.84 | $34.67 | $69.18 |
United Setting Professional Modifier None (both parts) Typical Low $12.02 Median $18.20 Typical High $26.92 | Professional | None (both parts) | $12.02 | $18.20 | $26.92 |
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 $8.71 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $8.71 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $3.47 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $2.63 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.74 | $2.88 | $2.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.75 Median $14.13 Typical High $27.54 | Professional | 26 · Professional part | $11.75 | $14.13 | $27.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $43.65 Median $52.48 Typical High $128.82 | Professional | 50 · Both sides | $43.65 | $52.48 | $128.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.45 Median $17.38 Typical High $42.66 | Professional | 51 · Multiple procedures | $14.45 | $17.38 | $42.66 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.75 Median $7.08 Typical High $16.98 | Professional | 80 · Assistant surgeon | $5.75 | $7.08 | $16.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.07 Median $4.90 Typical High $12.02 | Professional | 81 · Minimal assistant surgeon | $4.07 | $4.90 | $12.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.07 Median $4.90 Typical High $12.02 | Professional | 82 · Assistant surgeon, no resident | $4.07 | $4.90 | $12.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.07 Median $4.90 Typical High $12.02 | Professional | AS · PA/NP assist | $4.07 | $4.90 | $12.02 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | SH · Second concurrent infusion | $17.38 | $17.38 | $17.38 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | SJ · Third+ concurrent infusion | $17.38 | $17.38 | $17.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $17.38 Median $20.89 Typical High $41.69 | Professional | TC · Technical part | $17.38 | $20.89 | $41.69 |
Where North Carolina sits
The same service costs 8.9 times more in North Dakota than in Colorado. 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· 49th of 51
$20.89
ND $174CO $19.50
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.