How much rates vary
Facilitymedian $100 · 10th to 90th $49 to $115Professionalmedian $117 · 10th to 90th $72 to $129
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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $114.82 Typical High $114.82 | Professional | None (both parts) | $74.13 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $117.49 Median $141.25 Typical High $162.18 | Professional | None (both parts) | $117.49 | $141.25 | $162.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Facility | None | $125.89 | $125.89 | $151.36 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $89.13 Median $117.49 Typical High $154.88 | Professional | None (both parts) | $89.13 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $72.44 | $100.00 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $107.15 | Professional | None | $95.50 | $102.33 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $125.89 | Facility | None | $48.98 | $83.18 | $125.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $85.11 Median $107.15 Typical High $186.21 | Professional | None (both parts) | $85.11 | $107.15 | $186.21 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Facility | None | $60.26 | $60.26 | $75.86 |
United Setting Professional Modifier None (both parts) Typical Low $58.88 Median $75.86 Typical High $114.82 | Professional | None (both parts) | $58.88 | $75.86 | $114.82 |
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 $38.02 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $38.02 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $15.14 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $11.48 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $11.48 | $11.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $43.65 Median $45.71 Typical High $102.33 | Professional | 26 · Professional part | $43.65 | $45.71 | $102.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $162.18 Typical High $524.81 | Professional | 50 · Both sides | $128.82 | $162.18 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $53.70 Typical High $173.78 | Professional | 51 · Multiple procedures | $42.66 | $53.70 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $21.38 Typical High $69.18 | Professional | 80 · Assistant surgeon | $17.38 | $21.38 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $15.14 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $12.02 | $15.14 | $48.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $15.14 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $15.14 | $48.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $15.14 Typical High $48.98 | Professional | AS · PA/NP assist | $12.02 | $15.14 | $48.98 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | SH · Second concurrent infusion | $42.66 | $42.66 | $42.66 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | SJ · Third+ concurrent infusion | $42.66 | $42.66 | $42.66 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $64.57 Median $69.18 Typical High $154.88 | Professional | TC · Technical part | $64.57 | $69.18 | $154.88 |
Where North Carolina sits
The same service costs 2.9 times more in Montana 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· 21st of 51
$115
MT $209FL $72.44
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.