How much rates vary
Facilitymedian $38 · 10th to 90th $38 to $78Professionalmedian $58 · 10th to 90th $44 to $78
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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $45.71 | $77.62 | $77.62 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $54.95 Median $57.54 Typical High $60.26 | Professional | None (both parts) | $54.95 | $57.54 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $38.02 Typical High $38.02 | Professional | None (both parts) | $27.54 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $60.26 Typical High $83.18 | Facility | None | $40.74 | $60.26 | $83.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $60.26 Median $75.86 Typical High $117.49 | Professional | None (both parts) | $60.26 | $75.86 | $117.49 |
United Setting Professional Modifier None (both parts) Typical Low $33.11 Median $48.98 Typical High $72.44 | Professional | None (both parts) | $33.11 | $48.98 | $72.44 |
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 $23.44 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $23.44 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $9.55 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $7.08 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.79 | $7.76 | $7.76 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.30 Median $31.62 Typical High $58.88 | Professional | 26 · Professional part | $26.30 | $31.62 | $58.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $112.20 Typical High $281.84 | Professional | 50 · Both sides | $89.13 | $112.20 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $37.15 Typical High $93.33 | Professional | 51 · Multiple procedures | $30.20 | $37.15 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $15.14 Typical High $37.15 | Professional | 80 · Assistant surgeon | $12.02 | $15.14 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $10.47 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $8.32 | $10.47 | $26.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $10.47 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $10.47 | $26.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $10.47 Typical High $26.30 | Professional | AS · PA/NP assist | $8.32 | $10.47 | $26.30 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | SH · Second concurrent infusion | $30.20 | $30.20 | $30.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | SJ · Third+ concurrent infusion | $30.20 | $30.20 | $30.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $38.90 Median $46.77 Typical High $83.18 | Professional | TC · Technical part | $38.90 | $46.77 | $83.18 |
Where North Carolina sits
The same service costs 49.0 times more in North Dakota 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· 22nd of 51
$57.54
ND $120HI $2.45
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.