How much rates vary
Facilitymedian $219 · 10th to 90th $110 to $398Professionalmedian $347 · 10th to 90th $200 to $398
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $204.17 | $398.11 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $446.68 | Facility | None | $371.54 | $371.54 | $446.68 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $263.03 Median $346.74 Typical High $457.09 | Professional | None (both parts) | $263.03 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $218.78 Typical High $223.87 | Professional | None (both parts) | $158.49 | $218.78 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $269.15 | Professional | None | $181.97 | $199.53 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $245.47 Typical High $398.11 | Facility | None | $109.65 | $245.47 | $398.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $316.23 Typical High $537.03 | Professional | None (both parts) | $251.19 | $316.23 | $537.03 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $169.82 | Facility | None | $36.31 | $36.31 | $169.82 |
United Setting Professional Modifier None (both parts) Typical Low $147.91 Median $213.80 Typical High $263.03 | Professional | None (both parts) | $147.91 | $213.80 | $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 $102.33 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $102.33 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $41.69 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $30.90 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $20.42 | $39.81 | $39.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $134.90 Typical High $302.00 | Professional | 26 · Professional part | $125.89 | $134.90 | $302.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $478.63 Typical High $1,513.56 | Professional | 50 · Both sides | $380.19 | $478.63 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $158.49 Typical High $512.86 | Professional | 51 · Multiple procedures | $125.89 | $158.49 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $63.10 Typical High $204.17 | Professional | 80 · Assistant surgeon | $50.12 | $63.10 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $44.67 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $35.48 | $44.67 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $44.67 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $44.67 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $44.67 Typical High $141.25 | Professional | AS · PA/NP assist | $35.48 | $44.67 | $141.25 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SH · Second concurrent infusion | $125.89 | $125.89 | $125.89 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SJ · Third+ concurrent infusion | $125.89 | $125.89 | $125.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $190.55 Median $204.17 Typical High $457.09 | Professional | TC · Technical part | $190.55 | $204.17 | $457.09 |
Where North Carolina sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 3rd of 51
$347
GA $372AK $102
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.