How much rates vary
Facilitymedian $44 · 10th to 90th $22 to $69Professionalmedian $60 · 10th to 90th $37 to $69
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $38.90 | $69.18 | $69.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $77.62 | Facility | None | $64.57 | $64.57 | $77.62 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $57.54 Median $60.26 Typical High $64.57 | Professional | None (both parts) | $57.54 | $60.26 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $31.62 Median $43.65 Typical High $43.65 | Professional | None (both parts) | $31.62 | $43.65 | $43.65 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $51.29 | Professional | None | $36.31 | $39.81 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $69.18 Typical High $79.43 | Facility | None | $22.39 | $69.18 | $79.43 |
Medcost Setting Professional Modifier None (both parts) Typical Low $44.67 Median $57.54 Typical High $93.33 | Professional | None (both parts) | $44.67 | $57.54 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $26.92 Median $38.90 Typical High $52.48 | Professional | None (both parts) | $26.92 | $38.90 | $52.48 |
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 $19.50 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $19.50 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $7.76 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $5.89 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $6.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $23.44 Typical High $52.48 | Professional | 26 · Professional part | $22.91 | $23.44 | $52.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $85.11 Typical High $269.15 | Professional | 50 · Both sides | $67.61 | $85.11 | $269.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $28.18 Typical High $89.13 | Professional | 51 · Multiple procedures | $22.39 | $28.18 | $89.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.91 Median $11.48 Typical High $35.48 | Professional | 80 · Assistant surgeon | $8.91 | $11.48 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $7.94 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $6.31 | $7.94 | $25.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $7.94 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $7.94 | $25.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.31 Median $7.94 Typical High $25.12 | Professional | AS · PA/NP assist | $6.31 | $7.94 | $25.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | SH · Second concurrent infusion | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | SJ · Third+ concurrent infusion | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $35.48 Typical High $79.43 | Professional | TC · Technical part | $33.88 | $35.48 | $79.43 |
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
$60.26
MT $83.18DE $31.62
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.