How much rates vary
Facilitymedian $126 · 10th to 90th $59 to $214Professionalmedian $186 · 10th to 90th $112 to $214
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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None (both parts) Typical Low $109.65 Median $213.80 Typical High $213.80 | Professional | None (both parts) | $109.65 | $213.80 | $213.80 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | None (both parts) | $162.18 | $186.21 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $91.20 | $125.89 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $147.91 | Professional | None | $85.11 | $91.20 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $213.80 | Facility | None | $58.88 | $134.90 | $213.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $138.04 Median $173.78 Typical High $295.12 | Professional | None (both parts) | $138.04 | $173.78 | $295.12 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $117.49 Typical High $144.54 | Professional | None (both parts) | $81.28 | $117.49 | $144.54 |
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 $56.23 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $56.23 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $22.39 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $16.98 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.22 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $69.18 Median $74.13 Typical High $165.96 | Professional | 26 · Professional part | $69.18 | $74.13 | $165.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $257.04 Typical High $831.76 | Professional | 50 · Both sides | $208.93 | $257.04 | $831.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $85.11 Typical High $275.42 | Professional | 51 · Multiple procedures | $69.18 | $85.11 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $34.67 Typical High $109.65 | Professional | 80 · Assistant surgeon | $27.54 | $34.67 | $109.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $23.99 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $19.50 | $23.99 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $23.99 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $23.99 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $23.99 Typical High $77.62 | Professional | AS · PA/NP assist | $19.50 | $23.99 | $77.62 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | SH · Second concurrent infusion | $69.18 | $69.18 | $69.18 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | SJ · Third+ concurrent infusion | $69.18 | $69.18 | $69.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $102.33 Median $109.65 Typical High $245.47 | Professional | TC · Technical part | $102.33 | $109.65 | $245.47 |
Where North Carolina sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 7th of 51
$186
HI $219DE $91.20
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.