How much rates vary
Facilitymedian $245 · 10th to 90th $126 to $347Professionalmedian $302 · 10th to 90th $182 to $347
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $346.74 Typical High $346.74 | Professional | None (both parts) | $194.98 | $346.74 | $346.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $389.05 | Facility | None | $323.59 | $323.59 | $389.05 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $229.09 Median $302.00 Typical High $398.11 | Professional | None (both parts) | $229.09 | $302.00 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | None (both parts) | $177.83 | $245.47 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $263.03 | Professional | None | $190.55 | $204.17 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $213.80 Typical High $380.19 | Facility | None | $125.89 | $213.80 | $380.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $218.78 Median $275.42 Typical High $467.74 | Professional | None (both parts) | $218.78 | $275.42 | $467.74 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Facility | None | $147.91 | $147.91 | $204.17 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $194.98 Typical High $263.03 | Professional | None (both parts) | $151.36 | $194.98 | $263.03 |
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 $97.72 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $97.72 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $38.90 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $29.51 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $109.65 Median $117.49 Typical High $263.03 | Professional | 26 · Professional part | $109.65 | $117.49 | $263.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $416.87 Typical High $1,348.96 | Professional | 50 · Both sides | $331.13 | $416.87 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $138.04 Typical High $446.68 | Professional | 51 · Multiple procedures | $109.65 | $138.04 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $54.95 Typical High $177.83 | Professional | 80 · Assistant surgeon | $44.67 | $54.95 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | AS · PA/NP assist | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | SH · Second concurrent infusion | $109.65 | $109.65 | $109.65 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | SJ · Third+ concurrent infusion | $109.65 | $109.65 | $109.65 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $165.96 Median $177.83 Typical High $398.11 | Professional | TC · Technical part | $165.96 | $177.83 | $398.11 |
Where North Carolina sits
The same service costs 2.9 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· 18th of 51
$302
MT $513DE $178
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.