How much rates vary
Facilitymedian $178 · 10th to 90th $22 to $195Professionalmedian $178 · 10th to 90th $102 to $245
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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $204.17 | Professional | None | $131.83 | $194.98 | $204.17 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $147.91 Typical High $158.49 | Professional | UE · Used equipment | $81.28 | $147.91 | $158.49 |
Ambetter Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $35.48 | Facility | None | $29.51 | $29.51 | $35.48 |
BCBS North Carolina Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | RR · Rental | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | None | $151.36 | $177.83 | $177.83 |
Cigna Setting Professional Modifier RR · Rental Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | RR · Rental | $16.98 | $17.78 | $17.78 |
Medcost Setting Professional Modifier RR · Rental Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | RR · Rental | $19.05 | $20.89 | $20.89 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $194.98 Typical High $213.80 | Facility | None | $22.39 | $194.98 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | None | $218.78 | $245.47 | $245.47 |
Medcost Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | RR · Rental | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $199.53 | Professional | None | $87.10 | $134.90 | $199.53 |
United Setting Professional Modifier RR · Rental Typical Low $10.72 Median $15.85 Typical High $26.30 | Professional | RR · Rental | $10.72 | $15.85 | $26.30 |
United Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $102.33 Typical High $147.91 | Professional | UE · Used equipment | $64.57 | $102.33 | $147.91 |
11 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 $97.72 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $38.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $30.20 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $30.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 50 · Both sides | $316.23 | $371.54 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 51 · Multiple procedures | $107.15 | $123.03 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $50.12 Typical High $50.12 | Professional | 80 · Assistant surgeon | $42.66 | $50.12 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $29.51 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $34.67 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | AS · PA/NP assist | $29.51 | $34.67 | $34.67 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | SH · Second concurrent infusion | $123.03 | $123.03 | $123.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | SJ · Third+ concurrent infusion | $123.03 | $123.03 | $123.03 |
Where North Carolina sits
The same service costs 22.4 times more in Kansas than in Illinois. 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· 31st of 51
$178
KS $447IL $19.95
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.