How much rates vary
Facilitymedian $98 · 10th to 90th $49 to $132Professionalmedian $115 · 10th to 90th $71 to $132
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $131.83 Typical High $131.83 | Professional | None (both parts) | $74.13 | $131.83 | $131.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $147.91 | Facility | None | $125.89 | $125.89 | $147.91 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $87.10 Median $114.82 Typical High $154.88 | Professional | None (both parts) | $87.10 | $114.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | None (both parts) | $70.79 | $97.72 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $100.00 | Professional | None | $91.20 | $97.72 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $144.54 | Facility | None | $48.98 | $83.18 | $144.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $85.11 Median $107.15 Typical High $181.97 | Professional | None (both parts) | $85.11 | $107.15 | $181.97 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $75.86 Typical High $102.33 | Professional | None (both parts) | $57.54 | $75.86 | $102.33 |
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 $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $37.15 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $14.79 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $11.22 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.41 | $13.18 | $13.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $42.66 Median $45.71 Typical High $102.33 | Professional | 26 · Professional part | $42.66 | $45.71 | $102.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $158.49 Typical High $512.86 | Professional | 50 · Both sides | $128.82 | $158.49 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $52.48 Typical High $169.82 | Professional | 51 · Multiple procedures | $42.66 | $52.48 | $169.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $21.38 Typical High $67.61 | Professional | 80 · Assistant surgeon | $16.98 | $21.38 | $67.61 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $14.79 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $12.02 | $14.79 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $14.79 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $14.79 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $14.79 Typical High $47.86 | Professional | AS · PA/NP assist | $12.02 | $14.79 | $47.86 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | SH · Second concurrent infusion | $42.66 | $42.66 | $42.66 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | SJ · Third+ concurrent infusion | $42.66 | $42.66 | $42.66 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $63.10 Median $67.61 Typical High $151.36 | Professional | TC · Technical part | $63.10 | $67.61 | $151.36 |
Where North Carolina sits
The same service costs 3.2 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· 18th of 51
$115
HI $224FL $70.79
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.