How much rates vary
Facilitymedian $16 · 10th to 90th $8 to $22Professionalmedian $23 · 10th to 90th $13 to $25
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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None (both parts) Typical Low $12.88 Median $22.39 Typical High $22.39 | Professional | None (both parts) | $12.88 | $22.39 | $22.39 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None (both parts) | $22.91 | $22.91 | $22.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $29.51 | Facility | None | $25.12 | $25.12 | $29.51 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $17.38 Median $22.91 Typical High $30.90 | Professional | None (both parts) | $17.38 | $22.91 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None (both parts) Typical Low $12.02 Median $16.22 Typical High $16.98 | Professional | None (both parts) | $12.02 | $16.22 | $16.98 |
Medcost Setting Professional Modifier None Typical Low $11.75 Median $12.59 Typical High $16.60 | Professional | None | $11.75 | $12.59 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $7.59 Median $16.60 Typical High $24.55 | Facility | None | $7.59 | $16.60 | $24.55 |
Medcost Setting Professional Modifier None (both parts) Typical Low $16.98 Median $21.88 Typical High $36.31 | Professional | None (both parts) | $16.98 | $21.88 | $36.31 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None (both parts) Typical Low $11.48 Median $15.14 Typical High $18.62 | Professional | None (both parts) | $11.48 | $15.14 | $18.62 |
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 $6.46 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $6.46 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $2.63 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $1.95 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.29 | $2.24 | $2.24 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $9.12 Typical High $20.42 | Professional | 26 · Professional part | $8.71 | $9.12 | $20.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $25.70 Median $33.11 Typical High $102.33 | Professional | 50 · Both sides | $25.70 | $33.11 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.51 Median $10.96 Typical High $33.88 | Professional | 51 · Multiple procedures | $8.51 | $10.96 | $33.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.39 Median $4.37 Typical High $13.49 | Professional | 80 · Assistant surgeon | $3.39 | $4.37 | $13.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.40 Median $3.09 Typical High $9.55 | Professional | 81 · Minimal assistant surgeon | $2.40 | $3.09 | $9.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.40 Median $3.09 Typical High $9.55 | Professional | 82 · Assistant surgeon, no resident | $2.40 | $3.09 | $9.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.40 Median $3.09 Typical High $9.55 | Professional | AS · PA/NP assist | $2.40 | $3.09 | $9.55 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | SH · Second concurrent infusion | $8.51 | $8.51 | $8.51 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | SJ · Third+ concurrent infusion | $8.51 | $8.51 | $8.51 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $13.18 Median $13.49 Typical High $30.20 | Professional | TC · Technical part | $13.18 | $13.49 | $30.20 |
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· 12th of 51
$22.39
HI $35.48DE $12.02
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.