How much rates vary
Facilitymedian $214 · 10th to 90th $112 to $302Professionalmedian $263 · 10th to 90th $158 to $302
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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $190.55 | $302.00 | $302.00 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None (both parts) | $316.23 | $316.23 | $316.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | None (both parts) | $199.53 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | None (both parts) | $158.49 | $213.80 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $257.04 | Professional | None | $213.80 | $229.09 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $331.13 | Facility | None | $112.20 | $190.55 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $194.98 Median $245.47 Typical High $416.87 | Professional | None (both parts) | $194.98 | $245.47 | $416.87 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Facility | None | $229.09 | $229.09 | $257.04 |
United Setting Professional Modifier None (both parts) Typical Low $131.83 Median $173.78 Typical High $245.47 | Professional | None (both parts) | $131.83 | $173.78 | $245.47 |
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 $95.50 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $38.02 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.05 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $97.72 Median $104.71 Typical High $234.42 | Professional | 26 · Professional part | $97.72 | $104.71 | $234.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $363.08 Typical High $1,174.90 | Professional | 50 · Both sides | $288.40 | $363.08 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $120.23 Typical High $389.05 | Professional | 51 · Multiple procedures | $97.72 | $120.23 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $48.98 Typical High $154.88 | Professional | 80 · Assistant surgeon | $38.90 | $48.98 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $33.88 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $26.92 | $33.88 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $33.88 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $33.88 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $33.88 Typical High $109.65 | Professional | AS · PA/NP assist | $26.92 | $33.88 | $109.65 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | SH · Second concurrent infusion | $97.72 | $97.72 | $97.72 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | SJ · Third+ concurrent infusion | $97.72 | $97.72 | $97.72 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $154.88 Typical High $346.74 | Professional | TC · Technical part | $144.54 | $154.88 | $346.74 |
Where North Carolina sits
The same service costs 4.4 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· 17th of 51
$263
HI $692FL $158
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.