How much rates vary
Facilitymedian $50 · 10th to 90th $26 to $68Professionalmedian $69 · 10th to 90th $44 to $69
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $43.65 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $43.65 | $67.61 | $67.61 |
BCBS North Carolina Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Facility | None | $75.86 | $75.86 | $91.20 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $60.26 | $69.18 | $69.18 |
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 $50.12 | Professional | None (both parts) | $37.15 | $50.12 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $58.88 | Professional | None | $42.66 | $45.71 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $26.30 Median $50.12 Typical High $74.13 | Facility | None | $26.30 | $50.12 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $51.29 Median $64.57 Typical High $109.65 | Professional | None (both parts) | $51.29 | $64.57 | $109.65 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None (both parts) Typical Low $34.67 Median $45.71 Typical High $61.66 | Professional | None (both parts) | $34.67 | $45.71 | $61.66 |
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 $22.39 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $22.39 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $8.91 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $6.61 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.47 | $6.76 | $6.76 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $27.54 Typical High $61.66 | Professional | 26 · Professional part | $25.70 | $27.54 | $61.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $97.72 Typical High $309.03 | Professional | 50 · Both sides | $75.86 | $97.72 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.70 Median $32.36 Typical High $102.33 | Professional | 51 · Multiple procedures | $25.70 | $32.36 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.23 Median $12.88 Typical High $41.69 | Professional | 80 · Assistant surgeon | $10.23 | $12.88 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.08 Median $9.12 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $7.08 | $9.12 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.08 Median $9.12 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $7.08 | $9.12 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.08 Median $9.12 Typical High $28.84 | Professional | AS · PA/NP assist | $7.08 | $9.12 | $28.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SH · Second concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SJ · Third+ concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $38.90 Median $40.74 Typical High $91.20 | Professional | TC · Technical part | $38.90 | $40.74 | $91.20 |
Where North Carolina sits
The same service costs 2.8 times more in Kansas 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· 16th of 51
$69.18
KS $107DE $38.90
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.