How much rates vary
Facilitymedian $417 · 10th to 90th $195 to $603Professionalmedian $525 · 10th to 90th $324 to $603
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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None (both parts) Typical Low $323.59 Median $602.56 Typical High $602.56 | Professional | None (both parts) | $323.59 | $602.56 | $602.56 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | None (both parts) | $524.81 | $630.96 | $630.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $501.19 Median $524.81 Typical High $691.83 | Professional | None (both parts) | $501.19 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | None (both parts) | $309.03 | $416.87 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $446.68 | Professional | None | $316.23 | $338.84 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $602.56 Typical High $691.83 | Facility | None | $194.98 | $602.56 | $691.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $407.38 Median $478.63 Typical High $812.83 | Professional | None (both parts) | $407.38 | $478.63 | $812.83 |
United Setting Professional Modifier None (both parts) Typical Low $234.42 Median $338.84 Typical High $457.09 | Professional | None (both parts) | $234.42 | $338.84 | $457.09 |
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 $169.82 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $67.61 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $50.12 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.88 | $60.26 | $60.26 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $204.17 Typical High $457.09 | Professional | 26 · Professional part | $190.55 | $204.17 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $724.44 Typical High $2,290.87 | Professional | 50 · Both sides | $616.60 | $724.44 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $239.88 Typical High $776.25 | Professional | 51 · Multiple procedures | $204.17 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $95.50 Typical High $309.03 | Professional | 80 · Assistant surgeon | $81.28 | $95.50 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $67.61 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $57.54 | $67.61 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $67.61 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $67.61 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $213.80 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $213.80 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | SH · Second concurrent infusion | $204.17 | $204.17 | $204.17 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | SJ · Third+ concurrent infusion | $204.17 | $204.17 | $204.17 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $288.40 Median $309.03 Typical High $691.83 | Professional | TC · Technical part | $288.40 | $309.03 | $691.83 |
Where North Carolina sits
The same service costs 2.2 times more in Montana 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· 17th of 51
$525
MT $692DE $309
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.