How much rates vary
Facilitymedian $724 · 10th to 90th $309 to $955Professionalmedian $832 · 10th to 90th $537 to $955
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 $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $954.99 Typical High $954.99 | Professional | None (both parts) | $512.86 | $954.99 | $954.99 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None (both parts) | $831.76 | $831.76 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $794.33 Median $831.76 Typical High $891.25 | Professional | None (both parts) | $794.33 | $831.76 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Facility | None | $724.44 | $724.44 | $851.14 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $724.44 Typical High $851.14 | Professional | None (both parts) | $537.03 | $724.44 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $707.95 | Professional | None | $501.19 | $537.03 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $954.99 Typical High $1,096.48 | Facility | None | $309.03 | $954.99 | $1,096.48 |
Medcost Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $1,288.25 | Professional | None (both parts) | $758.58 | $758.58 | $1,288.25 |
United Setting Professional Modifier None (both parts) Typical Low $371.54 Median $537.03 Typical High $724.44 | Professional | None (both parts) | $371.54 | $537.03 | $724.44 |
12 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 55 · Aftercare only Typical Low $79.43 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $79.43 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $53.70 | $95.50 | $95.50 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $323.59 Typical High $724.44 | Professional | 26 · Professional part | $302.00 | $323.59 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,148.15 Typical High $3,630.78 | Professional | 50 · Both sides | $1,148.15 | $1,148.15 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $380.19 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $380.19 | $380.19 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $151.36 Typical High $489.78 | Professional | 80 · Assistant surgeon | $151.36 | $151.36 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $107.15 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $107.15 | $107.15 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $107.15 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $107.15 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $107.15 Typical High $338.84 | Professional | AS · PA/NP assist | $107.15 | $107.15 | $338.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | SH · Second concurrent infusion | $380.19 | $380.19 | $380.19 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | SJ · Third+ concurrent infusion | $380.19 | $380.19 | $380.19 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $457.09 Median $489.78 Typical High $1,096.48 | Professional | TC · Technical part | $457.09 | $489.78 | $1,096.48 |
Where North Carolina sits
The same service costs 2.0 times more in Montana 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
$832
MT $1,096WV $537
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.