How much rates vary
Facilitymedian $135 · 10th to 90th $65 to $234Professionalmedian $204 · 10th to 90th $120 to $234
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $234.42 Typical High $234.42 | Professional | None (both parts) | $123.03 | $234.42 | $234.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $269.15 | Facility | None | $223.87 | $223.87 | $269.15 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $154.88 Median $204.17 Typical High $275.42 | Professional | None (both parts) | $154.88 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $134.90 Typical High $141.25 | Professional | None (both parts) | $100.00 | $134.90 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $134.90 | Professional | None | $104.71 | $112.20 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $147.91 Typical High $234.42 | Facility | None | $64.57 | $147.91 | $234.42 |
Medcost Setting Professional Modifier None (both parts) Typical Low $151.36 Median $190.55 Typical High $323.59 | Professional | None (both parts) | $151.36 | $190.55 | $323.59 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
United Setting Professional Modifier None (both parts) Typical Low $89.13 Median $128.82 Typical High $158.49 | Professional | None (both parts) | $89.13 | $128.82 | $158.49 |
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 $61.66 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $24.55 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $23.44 | $23.44 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $75.86 Median $81.28 Typical High $181.97 | Professional | 26 · Professional part | $75.86 | $81.28 | $181.97 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $281.84 Typical High $912.01 | Professional | 50 · Both sides | $229.09 | $281.84 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $95.50 Typical High $302.00 | Professional | 51 · Multiple procedures | $75.86 | $95.50 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $38.02 Typical High $120.23 | Professional | 80 · Assistant surgeon | $30.20 | $38.02 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $26.30 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $21.38 | $26.30 | $85.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $26.30 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $26.30 | $85.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $26.30 Typical High $85.11 | Professional | AS · PA/NP assist | $21.38 | $26.30 | $85.11 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | SH · Second concurrent infusion | $75.86 | $75.86 | $75.86 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | SJ · Third+ concurrent infusion | $75.86 | $75.86 | $75.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $120.23 Typical High $269.15 | Professional | TC · Technical part | $112.20 | $120.23 | $269.15 |
Where North Carolina sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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
$204
KS $389NJ $100
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.