How much rates vary
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 $72.44 Median $81.28 Typical High $97.72 | Facility | None | $72.44 | $81.28 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $100.00 | Professional | None | $63.10 | $81.28 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $177.83 | Professional | None | $63.10 | $104.71 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $97.72 Typical High $102.33 | Facility | None | $56.23 | $97.72 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $165.96 | Professional | None | $64.57 | $83.18 | $165.96 |
10 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 $33.11 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $33.11 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.02 Typical High $12.88 | Professional | 55 · Aftercare only | $9.77 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.13 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.61 | $8.13 | $8.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 51 · Multiple procedures | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 80 · Assistant surgeon | $16.60 | $16.60 | $16.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 81 · Minimal assistant surgeon | $11.75 | $11.75 | $11.75 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $11.75 | $11.75 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | AS · PA/NP assist | $11.75 | $11.75 | $11.75 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | SH · Second concurrent infusion | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | SJ · Third+ concurrent infusion | $41.69 | $41.69 | $41.69 |
Where North Carolina sits
The same service costs 2.1 times more in Oregon than in Alabama. 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· 24th of 51
$83.18
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.