How much rates vary
Facilitymedian $141 · 10th to 90th $60 to $186Professionalmedian $162 · 10th to 90th $100 to $186
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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $186.21 Typical High $186.21 | Professional | None (both parts) | $102.33 | $186.21 | $186.21 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | None (both parts) | $177.83 | $194.98 | $194.98 |
BCBS North Carolina Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $208.93 | Facility | None | $173.78 | $173.78 | $208.93 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $138.04 Median $162.18 Typical High $173.78 | Professional | None (both parts) | $138.04 | $162.18 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | None (both parts) | $102.33 | $141.25 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $138.04 | Professional | None | $97.72 | $104.71 | $138.04 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $186.21 Typical High $213.80 | Facility | None | $60.26 | $186.21 | $213.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $123.03 Median $151.36 Typical High $251.19 | Professional | None (both parts) | $123.03 | $151.36 | $251.19 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $104.71 Typical High $141.25 | Professional | None (both parts) | $72.44 | $104.71 | $141.25 |
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 $52.48 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $52.48 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $20.89 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $18.62 | $18.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $63.10 Typical High $141.25 | Professional | 26 · Professional part | $58.88 | $63.10 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $229.09 Typical High $707.95 | Professional | 50 · Both sides | $181.97 | $229.09 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $75.86 Typical High $239.88 | Professional | 51 · Multiple procedures | $61.66 | $75.86 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $30.90 Typical High $95.50 | Professional | 80 · Assistant surgeon | $24.55 | $30.90 | $95.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $21.38 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $16.98 | $21.38 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $21.38 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $21.38 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $21.38 Typical High $66.07 | Professional | AS · PA/NP assist | $16.98 | $21.38 | $66.07 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | SH · Second concurrent infusion | $61.66 | $61.66 | $61.66 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | SJ · Third+ concurrent infusion | $61.66 | $61.66 | $61.66 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $95.50 Typical High $213.80 | Professional | TC · Technical part | $89.13 | $95.50 | $213.80 |
Where North Carolina sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 14th of 51
$162
WY $209NJ $102
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.