How much rates vary
Facilitymedian $28 · 10th to 90th $11 to $28Professionalmedian $15 · 10th to 90th $12 to $21
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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $12.30 Median $20.89 Typical High $20.89 | Professional | None (both parts) | $12.30 | $20.89 | $20.89 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $14.45 Median $15.14 Typical High $16.60 | Professional | None (both parts) | $14.45 | $15.14 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $20.42 Median $28.18 Typical High $28.18 | Professional | None (both parts) | $20.42 | $28.18 | $28.18 |
Medcost Setting Facility Modifier None Typical Low $10.72 Median $12.02 Typical High $21.88 | Facility | None | $10.72 | $12.02 | $21.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.02 Median $19.95 Typical High $50.12 | Professional | None (both parts) | $12.02 | $19.95 | $50.12 |
United Setting Professional Modifier None (both parts) Typical Low $8.71 Median $13.18 Typical High $19.50 | Professional | None (both parts) | $8.71 | $13.18 | $19.50 |
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 $6.31 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $6.31 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $2.51 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $1.91 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.26 | $2.09 | $2.09 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $4.79 Median $8.32 Typical High $23.44 | Professional | 26 · Professional part | $4.79 | $8.32 | $23.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $18.20 Median $27.54 Typical High $93.33 | Professional | 50 · Both sides | $18.20 | $27.54 | $93.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.03 Median $9.12 Typical High $30.90 | Professional | 51 · Multiple procedures | $6.03 | $9.12 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.40 Median $3.72 Typical High $12.59 | Professional | 80 · Assistant surgeon | $2.40 | $3.72 | $12.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.70 Median $2.57 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $1.70 | $2.57 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.70 Median $2.57 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $1.70 | $2.57 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.70 Median $2.57 Typical High $8.71 | Professional | AS · PA/NP assist | $1.70 | $2.57 | $8.71 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | SH · Second concurrent infusion | $6.03 | $6.03 | $6.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | SJ · Third+ concurrent infusion | $6.03 | $6.03 | $6.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7.24 Median $12.59 Typical High $34.67 | Professional | TC · Technical part | $7.24 | $12.59 | $34.67 |
Where North Carolina sits
The same service costs 8.7 times more in Hawaii 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· 47th of 51
$15.14
HI $85.11KS $9.77
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.