How much rates vary
Facilitymedian $13 · 10th to 90th $6 to $17Professionalmedian $15 · 10th to 90th $9 to $17
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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.96 Median $17.38 Typical High $17.38 | Professional | None (both parts) | $10.96 | $17.38 | $17.38 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $11.48 Median $15.14 Typical High $19.95 | Professional | None (both parts) | $11.48 | $15.14 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None (both parts) Typical Low $9.77 Median $13.49 Typical High $13.49 | Professional | None (both parts) | $9.77 | $13.49 | $13.49 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $17.38 | Professional | None | $12.30 | $13.18 | $17.38 |
Medcost Setting Facility Modifier None Typical Low $6.31 Median $10.72 Typical High $19.05 | Facility | None | $6.31 | $10.72 | $19.05 |
Medcost Setting Professional Modifier None (both parts) Typical Low $10.96 Median $14.13 Typical High $23.44 | Professional | None (both parts) | $10.96 | $14.13 | $23.44 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None (both parts) Typical Low $7.59 Median $9.77 Typical High $13.80 | Professional | None (both parts) | $7.59 | $9.77 | $13.80 |
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 $5.50 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $5.50 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $2.19 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $1.66 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.12 | $1.74 | $1.74 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5.62 Median $5.89 Typical High $13.18 | Professional | 26 · Professional part | $5.62 | $5.89 | $13.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $16.60 Median $20.89 Typical High $66.07 | Professional | 50 · Both sides | $16.60 | $20.89 | $66.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.50 Median $7.08 Typical High $22.39 | Professional | 51 · Multiple procedures | $5.50 | $7.08 | $22.39 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.19 Median $2.82 Typical High $8.91 | Professional | 80 · Assistant surgeon | $2.19 | $2.82 | $8.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.55 Median $1.95 Typical High $6.17 | Professional | 81 · Minimal assistant surgeon | $1.55 | $1.95 | $6.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.55 Median $1.95 Typical High $6.17 | Professional | 82 · Assistant surgeon, no resident | $1.55 | $1.95 | $6.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.55 Median $1.95 Typical High $6.17 | Professional | AS · PA/NP assist | $1.55 | $1.95 | $6.17 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | SH · Second concurrent infusion | $5.50 | $5.50 | $5.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | SJ · Third+ concurrent infusion | $5.50 | $5.50 | $5.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $8.32 Median $8.91 Typical High $19.95 | Professional | TC · Technical part | $8.32 | $8.91 | $19.95 |
Where North Carolina sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 16th of 51
$15.14
AR $22.91KS $9.12
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.