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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $134.90 | Professional | None | $95.50 | $102.33 | $134.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | None | $128.82 | $128.82 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | None | $102.33 | $102.33 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $102.33 Typical High $123.03 | Facility | None | $39.81 | $102.33 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | None | $123.03 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $269.15 | Professional | None | $93.33 | $107.15 | $269.15 |
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 $46.77 Median $51.29 Typical High $64.57 | Professional | 52 · Reduced service | $46.77 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.42 Typical High $26.30 | Professional | 53 · Discontinued | $18.62 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.23 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.33 | $10.23 | $12.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 51 · Multiple procedures | $63.10 | $63.10 | $63.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 80 · Assistant surgeon | $25.12 | $25.12 | $25.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 81 · Minimal assistant surgeon | $17.38 | $17.38 | $17.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $17.38 | $17.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | AS · PA/NP assist | $17.38 | $17.38 | $17.38 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | SH · Second concurrent infusion | $63.10 | $63.10 | $63.10 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | SJ · Third+ concurrent infusion | $63.10 | $63.10 | $63.10 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 30th of 51
$112
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.