How much rates vary
Facilitymedian $69 · 10th to 90th $25 to $72Professionalmedian $68 · 10th to 90th $44 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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $42.66 | $66.07 | $66.07 |
BCBS North Carolina Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Facility | None | $72.44 | $72.44 | $87.10 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $66.07 Median $67.61 Typical High $74.13 | Professional | None (both parts) | $66.07 | $67.61 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $58.88 | $69.18 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $57.54 | Professional | None | $40.74 | $44.67 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $66.07 Typical High $79.43 | Facility | None | $25.12 | $66.07 | $79.43 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $61.66 Typical High $107.15 | Professional | None (both parts) | $52.48 | $61.66 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $33.88 Median $43.65 Typical High $60.26 | Professional | None (both parts) | $33.88 | $43.65 | $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 $21.38 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $21.38 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $8.51 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $6.46 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.27 | $6.61 | $6.61 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $26.30 Typical High $58.88 | Professional | 26 · Professional part | $24.55 | $26.30 | $58.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $93.33 Typical High $302.00 | Professional | 50 · Both sides | $79.43 | $93.33 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $30.90 Typical High $100.00 | Professional | 51 · Multiple procedures | $26.30 | $30.90 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $12.30 Typical High $39.81 | Professional | 80 · Assistant surgeon | $10.72 | $12.30 | $39.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $8.71 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $7.41 | $8.71 | $28.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $8.71 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $8.71 | $28.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $8.71 Typical High $28.18 | Professional | AS · PA/NP assist | $7.41 | $8.71 | $28.18 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SH · Second concurrent infusion | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SJ · Third+ concurrent infusion | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $37.15 Median $39.81 Typical High $89.13 | Professional | TC · Technical part | $37.15 | $39.81 | $89.13 |
Where North Carolina sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 18th of 51
$67.61
MT $93.33SC $46.77
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.