How much rates vary
Facilitymedian $60 · 10th to 90th $31 to $72Professionalmedian $74 · 10th to 90th $46 to $81
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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $52.48 | $72.44 | $72.44 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $56.23 Median $74.13 Typical High $97.72 | Professional | None (both parts) | $56.23 | $74.13 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $43.65 Median $60.26 Typical High $60.26 | Professional | None (both parts) | $43.65 | $60.26 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $67.61 | Professional | None | $44.67 | $47.86 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $52.48 Typical High $79.43 | Facility | None | $30.90 | $52.48 | $79.43 |
Medcost Setting Professional Modifier None (both parts) Typical Low $53.70 Median $67.61 Typical High $114.82 | Professional | None (both parts) | $53.70 | $67.61 | $114.82 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Facility | None | $64.57 | $64.57 | $67.61 |
United Setting Professional Modifier None (both parts) Typical Low $37.15 Median $47.86 Typical High $72.44 | Professional | None (both parts) | $37.15 | $47.86 | $72.44 |
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 $26.92 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $26.92 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $10.72 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $7.94 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $7.24 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $28.84 Typical High $64.57 | Professional | 26 · Professional part | $26.92 | $28.84 | $64.57 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $102.33 Typical High $323.59 | Professional | 50 · Both sides | $81.28 | $102.33 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $33.88 Typical High $109.65 | Professional | 51 · Multiple procedures | $26.92 | $33.88 | $109.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $43.65 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $43.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $9.55 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $7.59 | $9.55 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $9.55 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $9.55 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $9.55 Typical High $30.20 | Professional | AS · PA/NP assist | $7.59 | $9.55 | $30.20 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | SH · Second concurrent infusion | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | SJ · Third+ concurrent infusion | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $43.65 Typical High $97.72 | Professional | TC · Technical part | $40.74 | $43.65 | $97.72 |
Where North Carolina sits
The same service costs 3.6 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· 20th of 51
$72.44
HI $158DE $43.65
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.