How much rates vary
Facilitymedian $224 · 10th to 90th $93 to $269Professionalmedian $234 · 10th to 90th $148 to $269
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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $151.36 | $269.15 | $269.15 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | None (both parts) | $204.17 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | None (both parts) | $165.96 | $223.87 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $190.55 | Professional | None | $134.90 | $144.54 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $169.82 Typical High $295.12 | Facility | None | $93.33 | $169.82 | $295.12 |
Medcost Setting Professional Modifier None (both parts) Typical Low $173.78 Median $218.78 Typical High $371.54 | Professional | None (both parts) | $173.78 | $218.78 | $371.54 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $151.36 Typical High $204.17 | Professional | None (both parts) | $109.65 | $151.36 | $204.17 |
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 $75.86 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $75.86 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $30.90 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $22.91 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.14 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $93.33 Typical High $208.93 | Professional | 26 · Professional part | $87.10 | $93.33 | $208.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $323.59 Typical High $1,047.13 | Professional | 50 · Both sides | $263.03 | $323.59 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $109.65 Typical High $346.74 | Professional | 51 · Multiple procedures | $87.10 | $109.65 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $43.65 Typical High $138.04 | Professional | 80 · Assistant surgeon | $34.67 | $43.65 | $138.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $30.20 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $24.55 | $30.20 | $97.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $30.20 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $30.20 | $97.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $30.20 Typical High $97.72 | Professional | AS · PA/NP assist | $24.55 | $30.20 | $97.72 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | SH · Second concurrent infusion | $87.10 | $87.10 | $87.10 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | SJ · Third+ concurrent infusion | $87.10 | $87.10 | $87.10 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $128.82 Median $138.04 Typical High $309.03 | Professional | TC · Technical part | $128.82 | $138.04 | $309.03 |
Where North Carolina sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 18th of 51
$234
HI $525DC $155
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.