How much rates vary
Facilitymedian $191 · 10th to 90th $98 to $295Professionalmedian $263 · 10th to 90th $155 to $295
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $169.82 | $295.12 | $295.12 |
BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $338.84 | Facility | None | $281.84 | $281.84 | $338.84 |
BCBS Setting Professional Modifier None (both parts) Typical Low $199.53 Median $263.03 Typical High $346.74 | Professional | None (both parts) | $199.53 | $263.03 | $346.74 |
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 $194.98 | Professional | None (both parts) | $138.04 | $190.55 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $204.17 | Professional | None | $181.97 | $194.98 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $331.13 | Facility | None | $97.72 | $186.21 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $190.55 Median $239.88 Typical High $407.38 | Professional | None (both parts) | $190.55 | $239.88 | $407.38 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None (both parts) Typical Low $117.49 Median $169.82 Typical High $223.87 | Professional | None (both parts) | $117.49 | $169.82 | $223.87 |
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 $85.11 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $33.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $95.50 Median $102.33 Typical High $229.09 | Professional | 26 · Professional part | $95.50 | $102.33 | $229.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $363.08 Typical High $1,148.15 | Professional | 50 · Both sides | $288.40 | $363.08 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $120.23 Typical High $389.05 | Professional | 51 · Multiple procedures | $95.50 | $120.23 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $47.86 Typical High $154.88 | Professional | 80 · Assistant surgeon | $38.02 | $47.86 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | AS · PA/NP assist | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | SH · Second concurrent infusion | $95.50 | $95.50 | $95.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | SJ · Third+ concurrent infusion | $95.50 | $95.50 | $95.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $154.88 Typical High $346.74 | Professional | TC · Technical part | $144.54 | $154.88 | $346.74 |
Where North Carolina sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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
$263
HI $372DE $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.