How much rates vary
Facilitymedian $49 · 10th to 90th $25 to $76Professionalmedian $66 · 10th to 90th $40 to $76
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $40.74 Median $75.86 Typical High $75.86 | Professional | None (both parts) | $40.74 | $75.86 | $75.86 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $63.10 Median $66.07 Typical High $89.13 | Professional | None (both parts) | $63.10 | $66.07 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $48.98 Typical High $51.29 | Professional | None (both parts) | $35.48 | $48.98 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $51.29 | Professional | None | $35.48 | $38.02 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $47.86 Typical High $77.62 | Facility | None | $24.55 | $47.86 | $77.62 |
Medcost Setting Professional Modifier None (both parts) Typical Low $48.98 Median $61.66 Typical High $104.71 | Professional | None (both parts) | $48.98 | $61.66 | $104.71 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
United Setting Professional Modifier None (both parts) Typical Low $28.84 Median $41.69 Typical High $56.23 | Professional | None (both parts) | $28.84 | $41.69 | $56.23 |
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 $20.42 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $20.42 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $8.13 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $6.17 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.07 | $7.59 | $7.59 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $26.30 Typical High $58.88 | Professional | 26 · Professional part | $24.55 | $26.30 | $58.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $91.20 Typical High $295.12 | Professional | 50 · Both sides | $74.13 | $91.20 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $30.20 Typical High $97.72 | Professional | 51 · Multiple procedures | $24.55 | $30.20 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.77 Median $12.30 Typical High $38.90 | Professional | 80 · Assistant surgeon | $9.77 | $12.30 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.92 Median $8.51 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $6.92 | $8.51 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.92 Median $8.51 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $6.92 | $8.51 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $8.51 Typical High $27.54 | Professional | AS · PA/NP assist | $6.92 | $8.51 | $27.54 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | SH · Second concurrent infusion | $24.55 | $24.55 | $24.55 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | SJ · Third+ concurrent infusion | $24.55 | $24.55 | $24.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $38.90 Typical High $87.10 | Professional | TC · Technical part | $36.31 | $38.90 | $87.10 |
Where North Carolina sits
The same service costs 4.7 times more in Hawaii 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· 14th of 51
$66.07
HI $166DE $35.48
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.