How much rates vary
Facilitymedian $87 · 10th to 90th $45 to $120Professionalmedian $105 · 10th to 90th $63 to $120
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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $75.86 Median $120.23 Typical High $120.23 | Professional | None (both parts) | $75.86 | $120.23 | $120.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $79.43 Median $104.71 Typical High $141.25 | Professional | None (both parts) | $79.43 | $104.71 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $87.10 Typical High $87.10 | Professional | None (both parts) | $63.10 | $87.10 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $107.15 | Professional | None | $85.11 | $91.20 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $131.83 | Facility | None | $44.67 | $75.86 | $131.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $77.62 Median $97.72 Typical High $165.96 | Professional | None (both parts) | $77.62 | $97.72 | $165.96 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None (both parts) Typical Low $52.48 Median $69.18 Typical High $97.72 | Professional | None (both parts) | $52.48 | $69.18 | $97.72 |
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 $38.90 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $11.75 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $12.02 | $12.02 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $41.69 Typical High $93.33 | Professional | 26 · Professional part | $38.90 | $41.69 | $93.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $144.54 Typical High $467.74 | Professional | 50 · Both sides | $117.49 | $144.54 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $48.98 Typical High $154.88 | Professional | 51 · Multiple procedures | $38.90 | $48.98 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $19.50 Typical High $61.66 | Professional | 80 · Assistant surgeon | $15.49 | $19.50 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $13.49 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $10.96 | $13.49 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $13.49 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $13.49 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $13.49 Typical High $43.65 | Professional | AS · PA/NP assist | $10.96 | $13.49 | $43.65 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | SH · Second concurrent infusion | $38.90 | $38.90 | $38.90 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | SJ · Third+ concurrent infusion | $38.90 | $38.90 | $38.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $57.54 Median $61.66 Typical High $138.04 | Professional | TC · Technical part | $57.54 | $61.66 | $138.04 |
Where North Carolina sits
The same service costs 2.5 times more in Arkansas than in Florida. 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
$105
AR $158FL $64.57
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.