How much rates vary
Facilitymedian $316 · 10th to 90th $162 to $501Professionalmedian $437 · 10th to 90th $269 to $501
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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None (both parts) Typical Low $281.84 Median $501.19 Typical High $501.19 | Professional | None (both parts) | $281.84 | $501.19 | $501.19 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None (both parts) | $512.86 | $512.86 | $512.86 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $426.58 Median $436.52 Typical High $478.63 | Professional | None (both parts) | $426.58 | $436.52 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | None (both parts) | $229.09 | $316.23 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $371.54 | Professional | None | $263.03 | $281.84 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $501.19 Typical High $575.44 | Facility | None | $162.18 | $501.19 | $575.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $338.84 Median $398.11 Typical High $676.08 | Professional | None (both parts) | $338.84 | $398.11 | $676.08 |
United Setting Professional Modifier None (both parts) Typical Low $194.98 Median $281.84 Typical High $380.19 | Professional | None (both parts) | $194.98 | $281.84 | $380.19 |
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 $141.25 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $141.25 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $41.69 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $28.18 | $50.12 | $50.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $158.49 Median $169.82 Typical High $380.19 | Professional | 26 · Professional part | $158.49 | $169.82 | $380.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $602.56 Typical High $1,905.46 | Professional | 50 · Both sides | $512.86 | $602.56 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $199.53 Typical High $645.65 | Professional | 51 · Multiple procedures | $169.82 | $199.53 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $79.43 Typical High $257.04 | Professional | 80 · Assistant surgeon | $67.61 | $79.43 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $56.23 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $47.86 | $56.23 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $56.23 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $56.23 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $56.23 Typical High $177.83 | Professional | AS · PA/NP assist | $47.86 | $56.23 | $177.83 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | SH · Second concurrent infusion | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | SJ · Third+ concurrent infusion | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $239.88 Median $257.04 Typical High $575.44 | Professional | TC · Technical part | $239.88 | $257.04 | $575.44 |
Where North Carolina sits
The same service costs 2.6 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· 15th of 51
$437
MT $589DE $229
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.