How much rates vary
Facilitymedian $219 · 10th to 90th $98 to $263Professionalmedian $229 · 10th to 90th $145 to $263
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $151.36 | $263.03 | $263.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $302.00 | Facility | None | $251.19 | $251.19 | $302.00 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $173.78 Median $229.09 Typical High $309.03 | Professional | None (both parts) | $173.78 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | None (both parts) | $158.49 | $218.78 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $204.17 | Professional | None | $158.49 | $169.82 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $165.96 Typical High $288.40 | Facility | None | $97.72 | $165.96 | $288.40 |
Medcost Setting Professional Modifier None (both parts) Typical Low $169.82 Median $213.80 Typical High $363.08 | Professional | None (both parts) | $169.82 | $213.80 | $363.08 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
United Setting Professional Modifier None (both parts) Typical Low $114.82 Median $151.36 Typical High $213.80 | Professional | None (both parts) | $114.82 | $151.36 | $213.80 |
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 $79.43 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $79.43 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $23.44 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $26.30 | $26.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $85.11 Median $91.20 Typical High $204.17 | Professional | 26 · Professional part | $85.11 | $91.20 | $204.17 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $316.23 Typical High $1,023.29 | Professional | 50 · Both sides | $251.19 | $316.23 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $107.15 Typical High $338.84 | Professional | 51 · Multiple procedures | $85.11 | $107.15 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $42.66 Typical High $134.90 | Professional | 80 · Assistant surgeon | $33.88 | $42.66 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $29.51 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $23.44 | $29.51 | $95.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $29.51 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $29.51 | $95.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $29.51 Typical High $95.50 | Professional | AS · PA/NP assist | $23.44 | $29.51 | $95.50 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | SH · Second concurrent infusion | $85.11 | $85.11 | $85.11 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | SJ · Third+ concurrent infusion | $85.11 | $85.11 | $85.11 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $134.90 Typical High $302.00 | Professional | TC · Technical part | $125.89 | $134.90 | $302.00 |
Where North Carolina sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$229
HI $525WV $158
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.