How much rates vary
Facilitymedian $89 · 10th to 90th $45 to $120Professionalmedian $107 · 10th to 90th $66 to $120
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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $120.23 Typical High $120.23 | Professional | None (both parts) | $69.18 | $120.23 | $120.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $107.15 Typical High $141.25 | Professional | None (both parts) | $81.28 | $107.15 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $66.07 | $89.13 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $107.15 | Professional | None | $85.11 | $93.33 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $134.90 | Facility | None | $44.67 | $75.86 | $134.90 |
Medcost Setting Professional Modifier None (both parts) Typical Low $77.62 Median $97.72 Typical High $165.96 | Professional | None (both parts) | $77.62 | $97.72 | $165.96 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $114.82 | Facility | None | $93.33 | $93.33 | $114.82 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $69.18 Typical High $97.72 | Professional | None (both parts) | $53.70 | $69.18 | $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 $37.15 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $37.15 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.41 | $12.02 | $12.02 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $41.69 Typical High $93.33 | Professional | 26 · Professional part | $38.90 | $41.69 | $93.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $147.91 Typical High $467.74 | Professional | 50 · Both sides | $117.49 | $147.91 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $48.98 Typical High $154.88 | Professional | 51 · Multiple procedures | $38.90 | $48.98 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $19.50 Typical High $63.10 | Professional | 80 · Assistant surgeon | $15.49 | $19.50 | $63.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $13.80 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $10.96 | $13.80 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $13.80 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $13.80 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $13.80 Typical High $43.65 | Professional | AS · PA/NP assist | $10.96 | $13.80 | $43.65 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | SH · Second concurrent infusion | $38.90 | $38.90 | $38.90 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | SJ · Third+ concurrent infusion | $38.90 | $38.90 | $38.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $63.10 Typical High $141.25 | Professional | TC · Technical part | $58.88 | $63.10 | $141.25 |
Where North Carolina sits
The same service costs 5.1 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· 16th of 51
$107
HI $339DE $66.07
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.