How much rates vary
Facilitymedian $68 · 10th to 90th $32 to $105Professionalmedian $91 · 10th to 90th $54 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 $60.26 Median $104.71 Typical High $104.71 | Facility | None | $60.26 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $56.23 | $104.71 | $104.71 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $36.31 Median $36.31 Typical High $81.28 | Professional | None (both parts) | $36.31 | $36.31 | $81.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $117.49 | Facility | None | $97.72 | $97.72 | $117.49 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $77.62 Median $91.20 Typical High $97.72 | Professional | None (both parts) | $77.62 | $91.20 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $67.61 Typical High $72.44 | Professional | None (both parts) | $50.12 | $67.61 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $75.86 | Professional | None | $47.86 | $51.29 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $64.57 Typical High $104.71 | Facility | None | $32.36 | $64.57 | $104.71 |
Medcost Setting Professional Modifier None (both parts) Typical Low $60.26 Median $83.18 Typical High $141.25 | Professional | None (both parts) | $60.26 | $83.18 | $141.25 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $57.54 Typical High $75.86 | Professional | None (both parts) | $39.81 | $57.54 | $75.86 |
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 $29.51 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $29.51 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $11.75 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $8.71 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.89 | $10.47 | $10.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $35.48 Typical High $79.43 | Professional | 26 · Professional part | $23.99 | $35.48 | $79.43 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $125.89 Typical High $398.11 | Professional | 50 · Both sides | $89.13 | $125.89 | $398.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $41.69 Typical High $134.90 | Professional | 51 · Multiple procedures | $30.20 | $41.69 | $134.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $16.98 Typical High $53.70 | Professional | 80 · Assistant surgeon | $12.02 | $16.98 | $53.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $11.75 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $8.32 | $11.75 | $37.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $11.75 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $11.75 | $37.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $11.75 Typical High $37.15 | Professional | AS · PA/NP assist | $8.32 | $11.75 | $37.15 |
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 $36.31 Median $53.70 Typical High $120.23 | Professional | TC · Technical part | $36.31 | $53.70 | $120.23 |
Where North Carolina sits
The same service costs 4.1 times more in Hawaii 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· 14th of 51
$91.20
HI $209DE $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.