How much rates vary
Facilitymedian $23 · 10th to 90th $12 to $36Professionalmedian $32 · 10th to 90th $19 to $36
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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $20.42 Median $36.31 Typical High $36.31 | Professional | None (both parts) | $20.42 | $36.31 | $36.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Facility | None | $34.67 | $34.67 | $40.74 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $27.54 Median $31.62 Typical High $33.88 | Professional | None (both parts) | $27.54 | $31.62 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None (both parts) Typical Low $16.98 Median $22.91 Typical High $22.91 | Professional | None (both parts) | $16.98 | $22.91 | $22.91 |
Medcost Setting Professional Modifier None Typical Low $19.50 Median $20.89 Typical High $26.92 | Professional | None | $19.50 | $20.89 | $26.92 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $36.31 Typical High $42.66 | Facility | None | $12.02 | $36.31 | $42.66 |
Medcost Setting Professional Modifier None (both parts) Typical Low $23.99 Median $30.90 Typical High $50.12 | Professional | None (both parts) | $23.99 | $30.90 | $50.12 |
United Setting Professional Modifier None (both parts) Typical Low $14.13 Median $20.42 Typical High $27.54 | Professional | None (both parts) | $14.13 | $20.42 | $27.54 |
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 $10.23 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $10.23 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $4.07 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $3.09 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.04 | $3.63 | $3.63 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $12.59 Typical High $28.18 | Professional | 26 · Professional part | $12.30 | $12.59 | $28.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $36.31 Median $46.77 Typical High $141.25 | Professional | 50 · Both sides | $36.31 | $46.77 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.02 Median $15.49 Typical High $46.77 | Professional | 51 · Multiple procedures | $12.02 | $15.49 | $46.77 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.79 Median $6.17 Typical High $18.62 | Professional | 80 · Assistant surgeon | $4.79 | $6.17 | $18.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.39 Median $4.37 Typical High $13.18 | Professional | 81 · Minimal assistant surgeon | $3.39 | $4.37 | $13.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.39 Median $4.37 Typical High $13.18 | Professional | 82 · Assistant surgeon, no resident | $3.39 | $4.37 | $13.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.39 Median $4.37 Typical High $13.18 | Professional | AS · PA/NP assist | $3.39 | $4.37 | $13.18 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | SH · Second concurrent infusion | $12.02 | $12.02 | $12.02 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | SJ · Third+ concurrent infusion | $12.02 | $12.02 | $12.02 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $18.62 Typical High $41.69 | Professional | TC · Technical part | $18.62 | $18.62 | $41.69 |
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
$31.62
MT $43.65DE $16.98
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.