How much rates vary
Facilitymedian $14 · 10th to 90th $14 to $15Professionalmedian $14 · 10th to 90th $11 to $46
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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None (both parts) Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None (both parts) | $14.45 | $14.45 | $14.45 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $22.91 | Facility | None | $19.05 | $19.05 | $22.91 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $17.78 Median $45.71 Typical High $60.26 | Professional | None (both parts) | $17.78 | $45.71 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | None (both parts) | $12.02 | $14.13 | $14.13 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $17.78 | Facility | None | $14.45 | $14.45 | $17.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None (both parts) | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None (both parts) Typical Low $7.24 Median $10.96 Typical High $15.85 | Professional | None (both parts) | $7.24 | $10.96 | $15.85 |
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 $7.24 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 26 · Professional part | $7.08 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 50 · Both sides | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 51 · Multiple procedures | $8.91 | $8.91 | $8.91 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 80 · Assistant surgeon | $3.55 | $3.55 | $3.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 81 · Minimal assistant surgeon | $2.45 | $2.45 | $2.45 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 82 · Assistant surgeon, no resident | $2.45 | $2.45 | $2.45 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | AS · PA/NP assist | $2.45 | $2.45 | $2.45 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | SH · Second concurrent infusion | $8.91 | $8.91 | $8.91 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | SJ · Third+ concurrent infusion | $8.91 | $8.91 | $8.91 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | TC · Technical part | $10.72 | $10.72 | $10.72 |
Where North Carolina sits
The same service costs 2.7 times more in North Dakota than in Ohio. 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· 13th of 51
$14.45
ND $19.50OH $7.24
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.