How much rates vary
Facilitymedian $74 · 10th to 90th $38 to $105Professionalmedian $91 · 10th to 90th $55 to $105
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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $64.57 | $104.71 | $104.71 |
BCBS North Carolina Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Facility | None | $100.00 | $100.00 | $120.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $69.18 Median $91.20 Typical High $123.03 | Professional | None (both parts) | $69.18 | $91.20 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | None (both parts) | $53.70 | $74.13 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $89.13 | Professional | None | $61.66 | $66.07 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $66.07 Typical High $114.82 | Facility | None | $38.02 | $66.07 | $114.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $67.61 Median $85.11 Typical High $144.54 | Professional | None (both parts) | $67.61 | $85.11 | $144.54 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $79.43 | Facility | None | $77.62 | $77.62 | $79.43 |
United Setting Professional Modifier None (both parts) Typical Low $44.67 Median $58.88 Typical High $83.18 | Professional | None (both parts) | $44.67 | $58.88 | $83.18 |
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 $32.36 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $32.36 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $12.88 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $9.77 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.46 | $10.47 | $10.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $36.31 Typical High $81.28 | Professional | 26 · Professional part | $33.88 | $36.31 | $81.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $128.82 Typical High $407.38 | Professional | 50 · Both sides | $102.33 | $128.82 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $42.66 Typical High $134.90 | Professional | 51 · Multiple procedures | $33.88 | $42.66 | $134.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $16.98 Typical High $53.70 | Professional | 80 · Assistant surgeon | $13.49 | $16.98 | $53.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.55 Median $12.02 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $9.55 | $12.02 | $38.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.55 Median $12.02 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $9.55 | $12.02 | $38.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.55 Median $12.02 Typical High $38.02 | Professional | AS · PA/NP assist | $9.55 | $12.02 | $38.02 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | SH · Second concurrent infusion | $33.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | SJ · Third+ concurrent infusion | $33.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $53.70 Typical High $120.23 | Professional | TC · Technical part | $51.29 | $53.70 | $120.23 |
Where North Carolina sits
The same service costs 3.1 times more in Hawaii than in Florida. 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
$91.20
HI $170FL $54.95
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.