How much rates vary
Facilitymedian $21 · 10th to 90th $11 to $34Professionalmedian $30 · 10th to 90th $17 to $34
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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $19.05 Median $33.88 Typical High $33.88 | Professional | None (both parts) | $19.05 | $33.88 | $33.88 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $25.12 Median $29.51 Typical High $31.62 | Professional | None (both parts) | $25.12 | $29.51 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $21.38 Typical High $21.38 | Professional | None (both parts) | $15.49 | $21.38 | $21.38 |
Medcost Setting Professional Modifier None Typical Low $17.78 Median $19.50 Typical High $25.12 | Professional | None | $17.78 | $19.50 | $25.12 |
Medcost Setting Facility Modifier None Typical Low $10.96 Median $33.88 Typical High $38.90 | Facility | None | $10.96 | $33.88 | $38.90 |
Medcost Setting Professional Modifier None (both parts) Typical Low $21.88 Median $28.18 Typical High $46.77 | Professional | None (both parts) | $21.88 | $28.18 | $46.77 |
United Setting Professional Modifier None (both parts) Typical Low $13.18 Median $19.05 Typical High $25.70 | Professional | None (both parts) | $13.18 | $19.05 | $25.70 |
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 $9.55 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $9.55 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $3.80 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $2.88 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.91 | $3.39 | $3.39 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $11.48 Typical High $25.70 | Professional | 26 · Professional part | $10.72 | $11.48 | $25.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $33.11 Median $41.69 Typical High $131.83 | Professional | 50 · Both sides | $33.11 | $41.69 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.96 Median $14.13 Typical High $43.65 | Professional | 51 · Multiple procedures | $10.96 | $14.13 | $43.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.37 Median $5.62 Typical High $17.38 | Professional | 80 · Assistant surgeon | $4.37 | $5.62 | $17.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.09 Median $3.89 Typical High $12.30 | Professional | 81 · Minimal assistant surgeon | $3.09 | $3.89 | $12.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.09 Median $3.89 Typical High $12.30 | Professional | 82 · Assistant surgeon, no resident | $3.09 | $3.89 | $12.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.09 Median $3.89 Typical High $12.30 | Professional | AS · PA/NP assist | $3.09 | $3.89 | $12.30 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | SH · Second concurrent infusion | $10.96 | $10.96 | $10.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | SJ · Third+ concurrent infusion | $10.96 | $10.96 | $10.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.22 Median $17.38 Typical High $38.90 | Professional | TC · Technical part | $16.22 | $17.38 | $38.90 |
Where North Carolina sits
The same service costs 2.9 times more in Montana than in Kansas. 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
$29.51
MT $40.74KS $14.13
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.