How much rates vary
Facilitymedian $263 · 10th to 90th $129 to $398Professionalmedian $407 · 10th to 90th $245 to $457
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $223.87 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $223.87 | $398.11 | $398.11 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $407.38 Median $489.78 Typical High $575.44 | Professional | None (both parts) | $407.38 | $489.78 | $575.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Facility | None | $446.68 | $446.68 | $537.03 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $316.23 Median $407.38 Typical High $549.54 | Professional | None (both parts) | $316.23 | $407.38 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $190.55 | $263.03 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | None | $251.19 | $269.15 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $295.12 Typical High $436.52 | Facility | None | $128.82 | $295.12 | $436.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $302.00 Median $380.19 Typical High $645.65 | Professional | None (both parts) | $302.00 | $380.19 | $645.65 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None (both parts) Typical Low $199.53 Median $269.15 Typical High $316.23 | Professional | None (both parts) | $199.53 | $269.15 | $316.23 |
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 $114.82 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $45.71 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $34.67 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.91 | $39.81 | $39.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $151.36 Median $162.18 Typical High $363.08 | Professional | 26 · Professional part | $151.36 | $162.18 | $363.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $562.34 Typical High $1,819.70 | Professional | 50 · Both sides | $457.09 | $562.34 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $190.55 Typical High $602.56 | Professional | 51 · Multiple procedures | $151.36 | $190.55 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $75.86 Typical High $245.47 | Professional | 80 · Assistant surgeon | $60.26 | $75.86 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $52.48 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $42.66 | $52.48 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $52.48 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $52.48 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $52.48 Typical High $169.82 | Professional | AS · PA/NP assist | $42.66 | $52.48 | $169.82 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | SH · Second concurrent infusion | $151.36 | $151.36 | $151.36 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | SJ · Third+ concurrent infusion | $151.36 | $151.36 | $151.36 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $239.88 Typical High $537.03 | Professional | TC · Technical part | $229.09 | $239.88 | $537.03 |
Where North Carolina sits
The same service costs 3.0 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· 15th of 51
$407
HI $562DE $191
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.