How much rates vary
Facilitymedian $295 · 10th to 90th $155 to $417Professionalmedian $363 · 10th to 90th $219 to $417
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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $234.42 Median $416.87 Typical High $416.87 | Professional | None (both parts) | $234.42 | $416.87 | $416.87 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $275.42 Median $363.08 Typical High $489.78 | Professional | None (both parts) | $275.42 | $363.08 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $218.78 | $295.12 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $316.23 | Professional | None | $234.42 | $251.19 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $457.09 | Facility | None | $154.88 | $257.04 | $457.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $269.15 Median $338.84 Typical High $575.44 | Professional | None (both parts) | $269.15 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
United Setting Professional Modifier None (both parts) Typical Low $181.97 Median $239.88 Typical High $323.59 | Professional | None (both parts) | $181.97 | $239.88 | $323.59 |
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 $117.49 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $117.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $35.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $41.69 | $41.69 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $134.90 Median $144.54 Typical High $323.59 | Professional | 26 · Professional part | $134.90 | $144.54 | $323.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $501.19 Typical High $1,621.81 | Professional | 50 · Both sides | $398.11 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $165.96 Typical High $537.03 | Professional | 51 · Multiple procedures | $134.90 | $165.96 | $537.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $67.61 Typical High $213.80 | Professional | 80 · Assistant surgeon | $53.70 | $67.61 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $46.77 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $37.15 | $46.77 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $46.77 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $46.77 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $46.77 Typical High $151.36 | Professional | AS · PA/NP assist | $37.15 | $46.77 | $151.36 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | SH · Second concurrent infusion | $134.90 | $134.90 | $134.90 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | SJ · Third+ concurrent infusion | $134.90 | $134.90 | $134.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $213.80 Typical High $478.63 | Professional | TC · Technical part | $199.53 | $213.80 | $478.63 |
Where North Carolina sits
The same service costs 4.2 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· 18th of 51
$363
HI $912DE $219
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.