How much rates vary
Facilitymedian $71 · 10th to 90th $36 to $112Professionalmedian $98 · 10th to 90th $58 to $112
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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $63.10 | $112.20 | $112.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $125.89 | Facility | None | $104.71 | $104.71 | $125.89 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $83.18 Median $97.72 Typical High $104.71 | Professional | None (both parts) | $83.18 | $97.72 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $51.29 | $70.79 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $83.18 | Professional | None | $58.88 | $64.57 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $112.20 Typical High $131.83 | Facility | None | $36.31 | $112.20 | $131.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $74.13 Median $93.33 Typical High $154.88 | Professional | None (both parts) | $74.13 | $93.33 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $63.10 Typical High $85.11 | Professional | None (both parts) | $43.65 | $63.10 | $85.11 |
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 $31.62 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $31.62 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $12.59 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $9.55 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.31 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $35.48 Median $38.02 Typical High $85.11 | Professional | 26 · Professional part | $35.48 | $38.02 | $85.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $138.04 Typical High $436.52 | Professional | 50 · Both sides | $112.20 | $138.04 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $46.77 Typical High $144.54 | Professional | 51 · Multiple procedures | $37.15 | $46.77 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $18.62 Typical High $57.54 | Professional | 80 · Assistant surgeon | $14.79 | $18.62 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $12.88 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $10.47 | $12.88 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $12.88 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $12.88 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $12.88 Typical High $40.74 | Professional | AS · PA/NP assist | $10.47 | $12.88 | $40.74 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | SH · Second concurrent infusion | $37.15 | $37.15 | $37.15 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | SJ · Third+ concurrent infusion | $37.15 | $37.15 | $37.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $53.70 Median $57.54 Typical High $128.82 | Professional | TC · Technical part | $53.70 | $57.54 | $128.82 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii 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· 17th of 51
$97.72
HI $132DE $51.29
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.