How much rates vary
Facilitymedian $234 · 10th to 90th $123 to $331Professionalmedian $288 · 10th to 90th $174 to $331
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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $331.13 Typical High $331.13 | Professional | None (both parts) | $186.21 | $331.13 | $331.13 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $218.78 Median $288.40 Typical High $389.05 | Professional | None (both parts) | $218.78 | $288.40 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | None (both parts) | $173.78 | $234.42 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | None | $199.53 | $218.78 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $363.08 | Facility | None | $123.03 | $208.93 | $363.08 |
Medcost Setting Professional Modifier None (both parts) Typical Low $213.80 Median $263.03 Typical High $457.09 | Professional | None (both parts) | $213.80 | $263.03 | $457.09 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $380.19 | Facility | None | $251.19 | $251.19 | $380.19 |
United Setting Professional Modifier None (both parts) Typical Low $144.54 Median $190.55 Typical High $269.15 | Professional | None (both parts) | $144.54 | $190.55 | $269.15 |
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 $97.72 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $97.72 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $38.90 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $29.51 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.50 | $33.11 | $33.11 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $107.15 Median $114.82 Typical High $257.04 | Professional | 26 · Professional part | $107.15 | $114.82 | $257.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $398.11 Typical High $1,288.25 | Professional | 50 · Both sides | $316.23 | $398.11 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $131.83 Typical High $426.58 | Professional | 51 · Multiple procedures | $107.15 | $131.83 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $53.70 Typical High $169.82 | Professional | 80 · Assistant surgeon | $42.66 | $53.70 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $37.15 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $29.51 | $37.15 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $37.15 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $37.15 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $37.15 Typical High $120.23 | Professional | AS · PA/NP assist | $29.51 | $37.15 | $120.23 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | SH · Second concurrent infusion | $107.15 | $107.15 | $107.15 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | SJ · Third+ concurrent infusion | $107.15 | $107.15 | $107.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $158.49 Median $169.82 Typical High $380.19 | Professional | TC · Technical part | $158.49 | $169.82 | $380.19 |
Where North Carolina sits
The same service costs 5.5 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
$288
HI $955FL $174
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.