How much rates vary
Facilitymedian $49 · 10th to 90th $19 to $52Professionalmedian $47 · 10th to 90th $29 to $52
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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $30.20 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $30.20 | $52.48 | $52.48 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $35.48 Median $46.77 Typical High $61.66 | Professional | None (both parts) | $35.48 | $46.77 | $61.66 |
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 $48.98 | Professional | None (both parts) | $35.48 | $48.98 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $41.69 | Professional | None | $28.18 | $30.20 | $41.69 |
Medcost Setting Facility Modifier None Typical Low $19.50 Median $33.11 Typical High $58.88 | Facility | None | $19.50 | $33.11 | $58.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $42.66 Typical High $72.44 | Professional | None (both parts) | $33.88 | $42.66 | $72.44 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $30.20 Typical High $40.74 | Professional | None (both parts) | $23.44 | $30.20 | $40.74 |
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 $15.49 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $15.49 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $6.17 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $4.57 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.09 | $5.25 | $5.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $18.20 Typical High $40.74 | Professional | 26 · Professional part | $17.38 | $18.20 | $40.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $64.57 Typical High $204.17 | Professional | 50 · Both sides | $51.29 | $64.57 | $204.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $21.38 Typical High $67.61 | Professional | 51 · Multiple procedures | $16.98 | $21.38 | $67.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $8.51 Typical High $27.54 | Professional | 80 · Assistant surgeon | $6.76 | $8.51 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $6.03 Typical High $19.05 | Professional | 81 · Minimal assistant surgeon | $4.79 | $6.03 | $19.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $6.03 Typical High $19.05 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $6.03 | $19.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $6.03 Typical High $19.05 | Professional | AS · PA/NP assist | $4.79 | $6.03 | $19.05 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | SH · Second concurrent infusion | $16.98 | $16.98 | $16.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | SJ · Third+ concurrent infusion | $16.98 | $16.98 | $16.98 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $27.54 Typical High $61.66 | Professional | TC · Technical part | $25.70 | $27.54 | $61.66 |
Where North Carolina sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 21st of 51
$46.77
HI $132DC $33.11
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.