How much rates vary
Facilitymedian $107 · 10th to 90th $43 to $117Professionalmedian $102 · 10th to 90th $63 to $117
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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $66.07 | $117.49 | $117.49 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $77.62 Median $102.33 Typical High $134.90 | Professional | None (both parts) | $77.62 | $102.33 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $77.62 | $107.15 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | None | $83.18 | $89.13 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $72.44 Typical High $128.82 | Facility | None | $42.66 | $72.44 | $128.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $75.86 Median $93.33 Typical High $158.49 | Professional | None (both parts) | $75.86 | $93.33 | $158.49 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $870.96 | Facility | None | $89.13 | $89.13 | $870.96 |
United Setting Professional Modifier None (both parts) Typical Low $51.29 Median $66.07 Typical High $89.13 | Professional | None (both parts) | $51.29 | $66.07 | $89.13 |
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 $33.11 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $33.11 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $13.18 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $9.77 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.61 | $11.75 | $11.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $39.81 Typical High $89.13 | Professional | 26 · Professional part | $38.02 | $39.81 | $89.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $141.25 Typical High $446.68 | Professional | 50 · Both sides | $112.20 | $141.25 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $46.77 Typical High $151.36 | Professional | 51 · Multiple procedures | $37.15 | $46.77 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $18.62 Typical High $60.26 | Professional | 80 · Assistant surgeon | $15.14 | $18.62 | $60.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $13.18 Typical High $41.69 | Professional | 81 · Minimal assistant surgeon | $10.47 | $13.18 | $41.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $13.18 Typical High $41.69 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $13.18 | $41.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $13.18 Typical High $41.69 | Professional | AS · PA/NP assist | $10.47 | $13.18 | $41.69 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | SH · Second concurrent infusion | $37.15 | $37.15 | $37.15 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | SJ · Third+ concurrent infusion | $37.15 | $37.15 | $37.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $60.26 Typical High $134.90 | Professional | TC · Technical part | $56.23 | $60.26 | $134.90 |
Where North Carolina sits
The same service costs 5.1 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· 20th of 51
$102
HI $355FL $69.18
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.