How much rates vary
Facilitymedian $214 · 10th to 90th $105 to $251Professionalmedian $219 · 10th to 90th $155 to $251
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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $138.04 | $251.19 | $251.19 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | None (both parts) | $194.98 | $218.78 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | None (both parts) | $158.49 | $213.80 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $229.09 | Professional | None | $173.78 | $186.21 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $177.83 Typical High $251.19 | Facility | None | $104.71 | $177.83 | $251.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $181.97 Median $229.09 Typical High $371.54 | Professional | None (both parts) | $181.97 | $229.09 | $371.54 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
United Setting Professional Modifier None (both parts) Typical Low $107.15 Median $162.18 Typical High $229.09 | Professional | None (both parts) | $107.15 | $162.18 | $229.09 |
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 $70.79 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $28.18 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $20.89 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.13 | $25.12 | $25.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $72.44 Median $97.72 Typical High $177.83 | Professional | 26 · Professional part | $72.44 | $97.72 | $177.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $338.84 Typical High $933.25 | Professional | 50 · Both sides | $275.42 | $338.84 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $114.82 Typical High $316.23 | Professional | 51 · Multiple procedures | $91.20 | $114.82 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $45.71 Typical High $125.89 | Professional | 80 · Assistant surgeon | $36.31 | $45.71 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.70 Median $31.62 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $25.70 | $31.62 | $89.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.70 Median $31.62 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $25.70 | $31.62 | $89.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $31.62 Typical High $89.13 | Professional | AS · PA/NP assist | $25.70 | $31.62 | $89.13 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | SH · Second concurrent infusion | $91.20 | $91.20 | $91.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | SJ · Third+ concurrent infusion | $91.20 | $91.20 | $91.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $109.65 Median $147.91 Typical High $245.47 | Professional | TC · Technical part | $109.65 | $147.91 | $245.47 |
Where North Carolina sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 14th of 51
$219
HI $437UT $151
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.