How much rates vary
Facilitymedian $28 · 10th to 90th $14 to $44Professionalmedian $38 · 10th to 90th $23 to $44
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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $43.65 Typical High $43.65 | Professional | None (both parts) | $24.55 | $43.65 | $43.65 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $32.36 Median $38.02 Typical High $39.81 | Professional | None (both parts) | $32.36 | $38.02 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $27.54 Typical High $27.54 | Professional | None (both parts) | $19.95 | $27.54 | $27.54 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $32.36 | Professional | None | $22.91 | $24.55 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $43.65 Typical High $50.12 | Facility | None | $14.13 | $43.65 | $50.12 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.90 Median $36.31 Typical High $58.88 | Professional | None (both parts) | $30.90 | $36.31 | $58.88 |
United Setting Professional Modifier None (both parts) Typical Low $16.98 Median $23.99 Typical High $33.11 | Professional | None (both parts) | $16.98 | $23.99 | $33.11 |
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 $12.30 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $12.30 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $4.90 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $3.63 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.45 | $4.37 | $4.37 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $14.45 Median $14.79 Typical High $33.11 | Professional | 26 · Professional part | $14.45 | $14.79 | $33.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $46.77 Median $53.70 Typical High $165.96 | Professional | 50 · Both sides | $46.77 | $53.70 | $165.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.49 Median $18.20 Typical High $56.23 | Professional | 51 · Multiple procedures | $15.49 | $18.20 | $56.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.17 Median $7.24 Typical High $22.39 | Professional | 80 · Assistant surgeon | $6.17 | $7.24 | $22.39 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.37 Median $5.01 Typical High $15.49 | Professional | 81 · Minimal assistant surgeon | $4.37 | $5.01 | $15.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.37 Median $5.01 Typical High $15.49 | Professional | 82 · Assistant surgeon, no resident | $4.37 | $5.01 | $15.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.37 Median $5.01 Typical High $15.49 | Professional | AS · PA/NP assist | $4.37 | $5.01 | $15.49 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | SH · Second concurrent infusion | $15.49 | $15.49 | $15.49 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | SJ · Third+ concurrent infusion | $15.49 | $15.49 | $15.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $21.38 Median $22.39 Typical High $50.12 | Professional | TC · Technical part | $21.38 | $22.39 | $50.12 |
Where North Carolina sits
The same service costs 2.6 times more in Montana 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
$38.02
MT $52.48DE $19.95
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.