How much rates vary
Facilitymedian $117 · 10th to 90th $50 to $151Professionalmedian $132 · 10th to 90th $78 to $151
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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $151.36 Typical High $151.36 | Professional | None (both parts) | $85.11 | $151.36 | $151.36 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $128.82 Median $131.83 Typical High $177.83 | Professional | None (both parts) | $128.82 | $131.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $85.11 | $117.49 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $112.20 | Professional | None | $81.28 | $87.10 | $112.20 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $95.50 Typical High $165.96 | Facility | None | $50.12 | $95.50 | $165.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $67.61 Median $123.03 Typical High $208.93 | Professional | None (both parts) | $67.61 | $123.03 | $208.93 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None (both parts) Typical Low $58.88 Median $85.11 Typical High $114.82 | Professional | None (both parts) | $58.88 | $85.11 | $114.82 |
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 $42.66 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $42.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $17.38 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $12.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $15.14 | $15.14 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $48.98 Median $52.48 Typical High $117.49 | Professional | 26 · Professional part | $48.98 | $52.48 | $117.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $181.97 Typical High $588.84 | Professional | 50 · Both sides | $100.00 | $181.97 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $61.66 Typical High $194.98 | Professional | 51 · Multiple procedures | $33.88 | $61.66 | $194.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $24.55 Typical High $77.62 | Professional | 80 · Assistant surgeon | $13.49 | $24.55 | $77.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $16.98 Typical High $54.95 | Professional | 81 · Minimal assistant surgeon | $9.33 | $16.98 | $54.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $16.98 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $16.98 | $54.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $16.98 Typical High $54.95 | Professional | AS · PA/NP assist | $9.33 | $16.98 | $54.95 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | SH · Second concurrent infusion | $33.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | SJ · Third+ concurrent infusion | $33.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $72.44 Median $77.62 Typical High $173.78 | Professional | TC · Technical part | $72.44 | $77.62 | $173.78 |
Where North Carolina sits
The same service costs 2.1 times more in Montana 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· 16th of 51
$132
MT $178FL $85.11
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.