How much rates vary
Facilitymedian $35 · 10th to 90th $14 to $39Professionalmedian $41 · 10th to 90th $26 to $43
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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $21.38 Median $38.90 Typical High $38.90 | Professional | None (both parts) | $21.38 | $38.90 | $38.90 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $40.74 | $40.74 | $40.74 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $39.81 Median $40.74 Typical High $44.67 | Professional | None (both parts) | $39.81 | $40.74 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Facility | None | $30.20 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $34.67 Typical High $34.67 | Professional | None (both parts) | $25.70 | $34.67 | $34.67 |
Medcost Setting Professional Modifier None Typical Low $20.89 Median $22.39 Typical High $29.51 | Professional | None | $20.89 | $22.39 | $29.51 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $28.84 Typical High $43.65 | Facility | None | $14.13 | $28.84 | $43.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.20 Median $38.02 Typical High $63.10 | Professional | None (both parts) | $30.20 | $38.02 | $63.10 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None (both parts) Typical Low $19.95 Median $26.30 Typical High $37.15 | Professional | None (both parts) | $19.95 | $26.30 | $37.15 |
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 $11.75 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $11.75 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $4.68 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $3.55 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.34 | $3.89 | $3.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.14 Median $15.85 Typical High $35.48 | Professional | 26 · Professional part | $15.14 | $15.85 | $35.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $44.67 Median $57.54 Typical High $177.83 | Professional | 50 · Both sides | $44.67 | $57.54 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $19.05 Typical High $60.26 | Professional | 51 · Multiple procedures | $15.14 | $19.05 | $60.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.03 Median $7.59 Typical High $23.99 | Professional | 80 · Assistant surgeon | $6.03 | $7.59 | $23.99 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.17 Median $5.37 Typical High $16.60 | Professional | 81 · Minimal assistant surgeon | $4.17 | $5.37 | $16.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.17 Median $5.37 Typical High $16.60 | Professional | 82 · Assistant surgeon, no resident | $4.17 | $5.37 | $16.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.17 Median $5.37 Typical High $16.60 | Professional | AS · PA/NP assist | $4.17 | $5.37 | $16.60 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | SH · Second concurrent infusion | $15.14 | $15.14 | $15.14 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | SJ · Third+ concurrent infusion | $15.14 | $15.14 | $15.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $22.91 Median $23.99 Typical High $53.70 | Professional | TC · Technical part | $22.91 | $23.99 | $53.70 |
Where North Carolina sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 16th of 51
$40.74
HI $77.62DC $24.55
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.