How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $1 · 10th to 90th $0 to $1
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 $0.55 Median $0.55 Typical High $0.55 | Facility | None | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $0.37 Median $0.55 Typical High $0.55 | Professional | None (both parts) | $0.37 | $0.55 | $0.55 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $0.49 Median $0.58 Typical High $0.62 | Professional | None (both parts) | $0.49 | $0.58 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Facility | None | $0.42 | $0.42 | $0.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $0.36 Median $0.42 Typical High $0.42 | Professional | None (both parts) | $0.36 | $0.42 | $0.42 |
Medcost Setting Professional Modifier None Typical Low $0.34 Median $0.37 Typical High $0.49 | Professional | None | $0.34 | $0.37 | $0.49 |
Medcost Setting Facility Modifier None Typical Low $0.22 Median $0.55 Typical High $0.66 | Facility | None | $0.22 | $0.55 | $0.66 |
Medcost Setting Professional Modifier None (both parts) Typical Low $0.52 Median $0.52 Typical High $0.89 | Professional | None (both parts) | $0.52 | $0.52 | $0.89 |
United Setting Professional Modifier None (both parts) Typical Low $0.28 Median $0.37 Typical High $0.51 | Professional | None (both parts) | $0.28 | $0.37 | $0.51 |
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 $0.19 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.19 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.07 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.06 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.04 | $0.06 | $0.06 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $0.21 Median $0.22 Typical High $0.50 | Professional | 26 · Professional part | $0.21 | $0.22 | $0.50 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $0.79 Median $0.79 Typical High $2.51 | Professional | 50 · Both sides | $0.79 | $0.79 | $2.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.26 Median $0.26 Typical High $0.83 | Professional | 51 · Multiple procedures | $0.26 | $0.26 | $0.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.10 Median $0.11 Typical High $0.33 | Professional | 80 · Assistant surgeon | $0.10 | $0.11 | $0.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.07 Median $0.07 Typical High $0.23 | Professional | 81 · Minimal assistant surgeon | $0.07 | $0.07 | $0.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.07 Median $0.07 Typical High $0.23 | Professional | 82 · Assistant surgeon, no resident | $0.07 | $0.07 | $0.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.07 Median $0.07 Typical High $0.23 | Professional | AS · PA/NP assist | $0.07 | $0.07 | $0.23 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | SH · Second concurrent infusion | $0.26 | $0.26 | $0.26 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | SJ · Third+ concurrent infusion | $0.26 | $0.26 | $0.26 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $0.32 Median $0.34 Typical High $0.76 | Professional | TC · Technical part | $0.32 | $0.34 | $0.76 |
Where North Carolina sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 20th of 51
$0.58
MT $0.81HI $0.35
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.