How much rates vary
Facilitymedian $81 · 10th to 90th $30 to $91Professionalmedian $72 · 10th to 90th $45 to $83
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $52.48 | $83.18 | $83.18 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $54.95 Median $72.44 Typical High $95.50 | Professional | None (both parts) | $54.95 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | None (both parts) | $58.88 | $81.28 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $70.79 | Professional | None | $43.65 | $46.77 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $91.20 | Facility | None | $30.20 | $51.29 | $91.20 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $67.61 Typical High $112.20 | Professional | None (both parts) | $52.48 | $67.61 | $112.20 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | None | $63.10 | $63.10 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $46.77 Typical High $63.10 | Professional | None (both parts) | $36.31 | $46.77 | $63.10 |
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 $26.30 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $26.30 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $10.47 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.25 | $8.32 | $8.32 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $28.18 Typical High $63.10 | Professional | 26 · Professional part | $26.92 | $28.18 | $63.10 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $100.00 Typical High $316.23 | Professional | 50 · Both sides | $79.43 | $100.00 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $33.88 Typical High $107.15 | Professional | 51 · Multiple procedures | $26.30 | $33.88 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $42.66 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $9.33 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $7.41 | $9.33 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $9.33 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $9.33 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $9.33 Typical High $29.51 | Professional | AS · PA/NP assist | $7.41 | $9.33 | $29.51 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SH · Second concurrent infusion | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SJ · Third+ concurrent infusion | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $42.66 Typical High $95.50 | Professional | TC · Technical part | $39.81 | $42.66 | $95.50 |
Where North Carolina sits
The same service costs 4.4 times more in Hawaii 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· 17th of 51
$72.44
HI $219FL $50.12
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.