How much rates vary
Facilitymedian $302 · 10th to 90th $100 to $339Professionalmedian $309 · 10th to 90th $234 to $389
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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $338.84 Typical High $338.84 | Professional | None (both parts) | $186.21 | $338.84 | $338.84 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $309.03 Median $457.09 Typical High $457.09 | Professional | None (both parts) | $309.03 | $457.09 | $457.09 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $302.00 Median $309.03 Typical High $389.05 | Professional | None (both parts) | $302.00 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $218.78 | $302.00 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $338.84 Typical High $389.05 | Facility | None | $100.00 | $338.84 | $389.05 |
Medcost Setting Professional Modifier None (both parts) Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None (both parts) | $389.05 | $389.05 | $524.81 |
United Setting Professional Modifier None (both parts) Typical Low $154.88 Median $239.88 Typical High $346.74 | Professional | None (both parts) | $154.88 | $239.88 | $346.74 |
16 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 $93.33 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $93.33 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $38.02 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $28.18 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.62 | $33.88 | $33.88 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | RR · Rental | $25.70 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $154.88 Median $154.88 Typical High $251.19 | Professional | 26 · Professional part | $154.88 | $154.88 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $588.84 Typical High $1,202.26 | Professional | 50 · Both sides | $588.84 | $588.84 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | 51 · Multiple procedures | $194.98 | $194.98 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $77.62 Typical High $158.49 | Professional | 80 · Assistant surgeon | $77.62 | $77.62 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $54.95 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $54.95 | $54.95 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $54.95 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $54.95 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $54.95 Typical High $112.20 | Professional | AS · PA/NP assist | $54.95 | $54.95 | $112.20 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | SH · Second concurrent infusion | $194.98 | $194.98 | $194.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | SJ · Third+ concurrent infusion | $194.98 | $194.98 | $194.98 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $234.42 Median $234.42 Typical High $371.54 | Professional | TC · Technical part | $234.42 | $234.42 | $371.54 |
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· 11th of 51
$309
HI $490UT $191
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.