How much rates vary
Facilitymedian $71 · 10th to 90th $36 to $100Professionalmedian $87 · 10th to 90th $52 to $100
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 $100.00 Median $100.00 Typical High $117.49 | Facility | None | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $41.69 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | None (both parts) | $74.13 | $87.10 | $87.10 |
BCBS North Carolina Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Facility | None | $93.33 | $93.33 | $112.20 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $74.13 Median $87.10 Typical High $93.33 | Professional | None (both parts) | $74.13 | $87.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $70.79 Typical High $74.13 | Professional | None (both parts) | $51.29 | $70.79 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $75.86 | Professional | None | $52.48 | $56.23 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $109.65 | Facility | None | $36.31 | $61.66 | $109.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $64.57 Median $79.43 Typical High $134.90 | Professional | None (both parts) | $64.57 | $79.43 | $134.90 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $67.61 | Facility | None | $52.48 | $52.48 | $67.61 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $56.23 Typical High $75.86 | Professional | None (both parts) | $43.65 | $56.23 | $75.86 |
11 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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | RR · Rental | $7.08 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $33.88 Typical High $75.86 | Professional | 26 · Professional part | $32.36 | $33.88 | $75.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $120.23 Typical High $380.19 | Professional | 50 · Both sides | $95.50 | $120.23 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $39.81 Typical High $128.82 | Professional | 51 · Multiple procedures | $32.36 | $39.81 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.88 Median $15.85 Typical High $51.29 | Professional | 80 · Assistant surgeon | $12.88 | $15.85 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.91 Median $11.22 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $8.91 | $11.22 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.91 Median $11.22 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $8.91 | $11.22 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.91 Median $11.22 Typical High $35.48 | Professional | AS · PA/NP assist | $8.91 | $11.22 | $35.48 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | SH · Second concurrent infusion | $32.36 | $32.36 | $32.36 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | SJ · Third+ concurrent infusion | $32.36 | $32.36 | $32.36 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $51.29 Typical High $114.82 | Professional | TC · Technical part | $47.86 | $51.29 | $114.82 |
Where North Carolina sits
The same service costs 2.8 times more in Wyoming 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· 18th of 51
$87.10
WY $145DE $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.