How much rates vary
Facilitymedian $417 · 10th to 90th $178 to $550Professionalmedian $490 · 10th to 90th $295 to $550
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $549.54 Typical High $549.54 | Professional | None (both parts) | $309.03 | $549.54 | $549.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $371.54 Median $489.78 Typical High $645.65 | Professional | None (both parts) | $371.54 | $489.78 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | None (both parts) | $309.03 | $416.87 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $371.54 | Professional | None | $281.84 | $302.00 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $616.60 | Facility | None | $177.83 | $346.74 | $616.60 |
Medcost Setting Professional Modifier None (both parts) Typical Low $354.81 Median $446.68 Typical High $758.58 | Professional | None (both parts) | $354.81 | $446.68 | $758.58 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
United Setting Professional Modifier None (both parts) Typical Low $213.80 Median $309.03 Typical High $407.38 | Professional | None (both parts) | $213.80 | $309.03 | $407.38 |
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 $158.49 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $63.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $46.77 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $31.62 | $54.95 | $54.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $190.55 Typical High $426.58 | Professional | 26 · Professional part | $177.83 | $190.55 | $426.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $660.69 Typical High $2,137.96 | Professional | 50 · Both sides | $537.03 | $660.69 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $223.87 Typical High $707.95 | Professional | 51 · Multiple procedures | $177.83 | $223.87 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $89.13 Typical High $288.40 | Professional | 80 · Assistant surgeon | $70.79 | $89.13 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $61.66 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $50.12 | $61.66 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $61.66 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $61.66 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $61.66 Typical High $199.53 | Professional | AS · PA/NP assist | $50.12 | $61.66 | $199.53 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | SH · Second concurrent infusion | $177.83 | $177.83 | $177.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | SJ · Third+ concurrent infusion | $177.83 | $177.83 | $177.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $269.15 Median $288.40 Typical High $645.65 | Professional | TC · Technical part | $269.15 | $288.40 | $645.65 |
Where North Carolina sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 17th of 51
$490
HI $871DC $302
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.