How much rates vary
Facilitymedian $191 · 10th to 90th $95 to $257Professionalmedian $224 · 10th to 90th $138 to $257
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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None (both parts) Typical Low $144.54 Median $257.04 Typical High $257.04 | Professional | None (both parts) | $144.54 | $257.04 | $257.04 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None (both parts) | $223.87 | $223.87 | $223.87 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $169.82 Median $223.87 Typical High $302.00 | Professional | None (both parts) | $169.82 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | None (both parts) | $138.04 | $190.55 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $194.98 | Professional | None | $138.04 | $147.91 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $162.18 Typical High $281.84 | Facility | None | $95.50 | $162.18 | $281.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $165.96 Median $208.93 Typical High $354.81 | Professional | None (both parts) | $165.96 | $208.93 | $354.81 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $194.98 | Facility | None | $190.55 | $190.55 | $194.98 |
United Setting Professional Modifier None (both parts) Typical Low $112.20 Median $147.91 Typical High $199.53 | Professional | None (both parts) | $112.20 | $147.91 | $199.53 |
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 $72.44 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $29.51 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.45 | $25.70 | $25.70 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $89.13 Typical High $199.53 | Professional | 26 · Professional part | $83.18 | $89.13 | $199.53 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $309.03 Typical High $1,000.00 | Professional | 50 · Both sides | $251.19 | $309.03 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $102.33 Typical High $331.13 | Professional | 51 · Multiple procedures | $83.18 | $102.33 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $41.69 Typical High $131.83 | Professional | 80 · Assistant surgeon | $33.11 | $41.69 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $28.84 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $23.44 | $28.84 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $28.84 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $28.84 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $28.84 Typical High $93.33 | Professional | AS · PA/NP assist | $23.44 | $28.84 | $93.33 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | SH · Second concurrent infusion | $83.18 | $83.18 | $83.18 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | SJ · Third+ concurrent infusion | $83.18 | $83.18 | $83.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $131.83 Typical High $295.12 | Professional | TC · Technical part | $123.03 | $131.83 | $295.12 |
Where North Carolina sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 19th of 51
$224
HI $479FL $138
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.