How much rates vary
Facilitymedian $25 · 10th to 90th $25 to $25Professionalmedian $8 · 10th to 90th $8 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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $25.12 | $25.12 | $25.12 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $26.30 | Facility | None | $25.12 | $25.12 | $26.30 |
Medcost Setting Professional Modifier None (both parts) Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None (both parts) | $8.32 | $8.32 | $8.32 |
9 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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 50 · Both sides | $12.59 | $12.59 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 51 · Multiple procedures | $4.17 | $4.17 | $4.17 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 80 · Assistant surgeon | $1.70 | $1.70 | $1.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | 81 · Minimal assistant surgeon | $1.17 | $1.17 | $1.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | 82 · Assistant surgeon, no resident | $1.17 | $1.17 | $1.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | AS · PA/NP assist | $1.17 | $1.17 | $1.17 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | SH · Second concurrent infusion | $4.17 | $4.17 | $4.17 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | SJ · Third+ concurrent infusion | $4.17 | $4.17 | $4.17 |