How much rates vary
Facilitymedian $145 · 10th to 90th $65 to $182Professionalmedian $158 · 10th to 90th $98 to $182
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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None (both parts) Typical Low $112.20 Median $181.97 Typical High $181.97 | Professional | None (both parts) | $112.20 | $181.97 | $181.97 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $120.23 Median $158.49 Typical High $208.93 | Professional | None (both parts) | $120.23 | $158.49 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | None (both parts) | $104.71 | $144.54 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $165.96 | Professional | None | $93.33 | $100.00 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $199.53 | Facility | None | $64.57 | $112.20 | $199.53 |
Medcost Setting Professional Modifier None (both parts) Typical Low $114.82 Median $144.54 Typical High $245.47 | Professional | None (both parts) | $114.82 | $144.54 | $245.47 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $77.62 Median $102.33 Typical High $138.04 | Professional | None (both parts) | $77.62 | $102.33 | $138.04 |
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 $60.26 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $60.26 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $24.55 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.02 | $18.20 | $18.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $61.66 Typical High $138.04 | Professional | 26 · Professional part | $57.54 | $61.66 | $138.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $218.78 Typical High $691.83 | Professional | 50 · Both sides | $173.78 | $218.78 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $72.44 Typical High $234.42 | Professional | 51 · Multiple procedures | $57.54 | $72.44 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $28.84 Typical High $93.33 | Professional | 80 · Assistant surgeon | $23.44 | $28.84 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $20.42 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $16.22 | $20.42 | $64.57 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $20.42 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $20.42 | $64.57 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $20.42 Typical High $64.57 | Professional | AS · PA/NP assist | $16.22 | $20.42 | $64.57 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | SH · Second concurrent infusion | $57.54 | $57.54 | $57.54 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | SJ · Third+ concurrent infusion | $57.54 | $57.54 | $57.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $93.33 Typical High $208.93 | Professional | TC · Technical part | $87.10 | $93.33 | $208.93 |
Where North Carolina sits
The same service costs 2.5 times more in Montana than in Florida. 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· 16th of 51
$158
MT $263FL $105
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.