How much rates vary
Facilitymedian $102 · 10th to 90th $46 to $129Professionalmedian $112 · 10th to 90th $69 to $129
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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $128.82 Typical High $128.82 | Professional | None (both parts) | $72.44 | $128.82 | $128.82 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $93.33 Median $134.90 Typical High $134.90 | Professional | None (both parts) | $93.33 | $134.90 | $134.90 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $85.11 Median $112.20 Typical High $151.36 | Professional | None (both parts) | $85.11 | $112.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | None (both parts) | $74.13 | $102.33 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $97.72 | Professional | None | $69.18 | $74.13 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $141.25 | Facility | None | $45.71 | $79.43 | $141.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $83.18 Median $104.71 Typical High $177.83 | Professional | None (both parts) | $83.18 | $104.71 | $177.83 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $72.44 Typical High $97.72 | Professional | None (both parts) | $53.70 | $72.44 | $97.72 |
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 $36.31 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $36.31 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $14.45 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $10.96 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.24 | $12.88 | $12.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $44.67 Typical High $100.00 | Professional | 26 · Professional part | $41.69 | $44.67 | $100.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $154.88 Typical High $501.19 | Professional | 50 · Both sides | $125.89 | $154.88 | $501.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $52.48 Typical High $165.96 | Professional | 51 · Multiple procedures | $41.69 | $52.48 | $165.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.60 Median $20.89 Typical High $66.07 | Professional | 80 · Assistant surgeon | $16.60 | $20.89 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $14.45 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $11.75 | $14.45 | $46.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $14.45 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $14.45 | $46.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $14.45 Typical High $46.77 | Professional | AS · PA/NP assist | $11.75 | $14.45 | $46.77 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | SH · Second concurrent infusion | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | SJ · Third+ concurrent infusion | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $63.10 Median $66.07 Typical High $147.91 | Professional | TC · Technical part | $63.10 | $66.07 | $147.91 |
Where North Carolina sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 19th of 51
$112
HI $214NJ $74.13
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.