How much rates vary
Facilitymedian $50 · 10th to 90th $25 to $63Professionalmedian $65 · 10th to 90th $39 to $72
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | None (both parts) | $41.69 | $63.10 | $63.10 |
BCBS North Carolina Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $85.11 | Facility | None | $70.79 | $70.79 | $85.11 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $50.12 Median $64.57 Typical High $87.10 | Professional | None (both parts) | $50.12 | $64.57 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $50.12 Typical High $52.48 | Professional | None (both parts) | $37.15 | $50.12 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $69.18 | Professional | None | $45.71 | $50.12 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $46.77 Typical High $69.18 | Facility | None | $25.12 | $46.77 | $69.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $47.86 Median $60.26 Typical High $102.33 | Professional | None (both parts) | $47.86 | $60.26 | $102.33 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | None | $32.36 | $32.36 | $38.90 |
United Setting Professional Modifier None (both parts) Typical Low $32.36 Median $42.66 Typical High $60.26 | Professional | None (both parts) | $32.36 | $42.66 | $60.26 |
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 $23.44 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $23.44 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $9.33 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $6.92 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.68 | $6.31 | $6.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $25.70 Typical High $57.54 | Professional | 26 · Professional part | $23.99 | $25.70 | $57.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $89.13 Typical High $288.40 | Professional | 50 · Both sides | $72.44 | $89.13 | $288.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.99 Median $30.20 Typical High $95.50 | Professional | 51 · Multiple procedures | $23.99 | $30.20 | $95.50 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $12.02 Typical High $38.90 | Professional | 80 · Assistant surgeon | $9.55 | $12.02 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.76 Median $8.32 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $6.76 | $8.32 | $26.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.76 Median $8.32 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $6.76 | $8.32 | $26.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.76 Median $8.32 Typical High $26.92 | Professional | AS · PA/NP assist | $6.76 | $8.32 | $26.92 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | SH · Second concurrent infusion | $23.99 | $23.99 | $23.99 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | SJ · Third+ concurrent infusion | $23.99 | $23.99 | $23.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $38.02 Typical High $85.11 | Professional | TC · Technical part | $36.31 | $38.02 | $85.11 |
Where North Carolina sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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
$64.57
AR $85.11CO $39.81
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.