How much rates vary
Facilitymedian $275 · 10th to 90th $83 to $295Professionalmedian $263 · 10th to 90th $200 to $331
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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $154.88 | $281.84 | $281.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $257.04 Median $263.03 Typical High $331.13 | Professional | None (both parts) | $257.04 | $263.03 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | None (both parts) | $204.17 | $275.42 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $281.84 Typical High $331.13 | Facility | None | $83.18 | $281.84 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $331.13 Median $331.13 Typical High $436.52 | Professional | None (both parts) | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None (both parts) Typical Low $131.83 Median $199.53 Typical High $288.40 | Professional | None (both parts) | $131.83 | $199.53 | $288.40 |
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 $79.43 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $79.43 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $31.62 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.85 | $28.18 | $28.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $131.83 Typical High $208.93 | Professional | 26 · Professional part | $131.83 | $131.83 | $208.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $1,000.00 | Professional | 50 · Both sides | $489.78 | $489.78 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $165.96 Typical High $338.84 | Professional | 51 · Multiple procedures | $165.96 | $165.96 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $66.07 Typical High $134.90 | Professional | 80 · Assistant surgeon | $66.07 | $66.07 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $45.71 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $45.71 | $45.71 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $45.71 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $45.71 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $45.71 Typical High $93.33 | Professional | AS · PA/NP assist | $45.71 | $45.71 | $93.33 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | SH · Second concurrent infusion | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | SJ · Third+ concurrent infusion | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $199.53 Typical High $316.23 | Professional | TC · Technical part | $199.53 | $199.53 | $316.23 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 9th of 51
$263
HI $417UT $162
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.