How much rates vary
Facilitymedian $117 · 10th to 90th $49 to $141Professionalmedian $126 · 10th to 90th $78 to $141
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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | None (both parts) | $81.28 | $141.25 | $141.25 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None (both parts) | $147.91 | $147.91 | $147.91 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $107.15 Median $125.89 Typical High $131.83 | Professional | None (both parts) | $107.15 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $117.49 Typical High $125.89 | Professional | None (both parts) | $85.11 | $117.49 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $120.23 | Professional | None | $70.79 | $75.86 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $89.13 Typical High $154.88 | Facility | None | $48.98 | $89.13 | $154.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $91.20 Median $114.82 Typical High $194.98 | Professional | None (both parts) | $91.20 | $114.82 | $194.98 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $81.28 Typical High $107.15 | Professional | None (both parts) | $57.54 | $81.28 | $107.15 |
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 $43.65 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $43.65 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $17.38 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $13.18 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.71 | $14.13 | $14.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $48.98 Typical High $109.65 | Professional | 26 · Professional part | $45.71 | $48.98 | $109.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $173.78 Typical High $549.54 | Professional | 50 · Both sides | $138.04 | $173.78 | $549.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $57.54 Typical High $181.97 | Professional | 51 · Multiple procedures | $45.71 | $57.54 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $22.91 Typical High $74.13 | Professional | 80 · Assistant surgeon | $18.20 | $22.91 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.88 Median $16.22 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $12.88 | $16.22 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.88 Median $16.22 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $12.88 | $16.22 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.88 Median $16.22 Typical High $51.29 | Professional | AS · PA/NP assist | $12.88 | $16.22 | $51.29 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | SH · Second concurrent infusion | $45.71 | $45.71 | $45.71 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | SJ · Third+ concurrent infusion | $45.71 | $45.71 | $45.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $69.18 Median $74.13 Typical High $165.96 | Professional | TC · Technical part | $69.18 | $74.13 | $165.96 |
Where North Carolina sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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
$126
HI $204CO $85.11
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.