How much rates vary
Facilitymedian $550 · 10th to 90th $257 to $813Professionalmedian $708 · 10th to 90th $427 to $813
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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $446.68 Median $812.83 Typical High $812.83 | Professional | None (both parts) | $446.68 | $812.83 | $812.83 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None (both parts) | $851.14 | $851.14 | $851.14 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $537.03 Median $707.95 Typical High $933.25 | Professional | None (both parts) | $537.03 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $549.54 Typical High $575.44 | Professional | None (both parts) | $398.11 | $549.54 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $537.03 | Professional | None | $371.54 | $398.11 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $501.19 Typical High $812.83 | Facility | None | $257.04 | $501.19 | $812.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $524.81 Median $645.65 Typical High $1,122.02 | Professional | None (both parts) | $524.81 | $645.65 | $1,122.02 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None (both parts) Typical Low $309.03 Median $446.68 Typical High $602.56 | Professional | None (both parts) | $309.03 | $446.68 | $602.56 |
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 $229.09 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $229.09 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $91.20 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $69.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $45.71 | $81.28 | $81.28 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $275.42 Typical High $616.60 | Professional | 26 · Professional part | $251.19 | $275.42 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $3,162.28 | Professional | 50 · Both sides | $776.25 | $977.24 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $323.59 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $257.04 | $323.59 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $128.82 Typical High $416.87 | Professional | 80 · Assistant surgeon | $104.71 | $128.82 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $91.20 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $72.44 | $91.20 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $91.20 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $91.20 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $91.20 Typical High $295.12 | Professional | AS · PA/NP assist | $72.44 | $91.20 | $295.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | SH · Second concurrent infusion | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | SJ · Third+ concurrent infusion | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $380.19 Median $416.87 Typical High $933.25 | Professional | TC · Technical part | $380.19 | $416.87 | $933.25 |
Where North Carolina sits
The same service costs 2.4 times more in Iowa 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· 15th of 51
$708
IA $955DE $398
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.