How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $9Professionalmedian $9 · 10th to 90th $5 to $115
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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None (both parts) | $4.57 | $4.57 | $4.57 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $45.71 Median $60.26 Typical High $114.82 | Professional | None (both parts) | $45.71 | $60.26 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None (both parts) Typical Low $6.76 Median $9.33 Typical High $9.33 | Professional | None (both parts) | $6.76 | $9.33 | $9.33 |
Medcost Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $5.50 | Facility | None | $4.57 | $4.57 | $5.50 |
Medcost Setting Professional Modifier None (both parts) Typical Low $8.91 Median $10.72 Typical High $10.72 | Professional | None (both parts) | $8.91 | $10.72 | $10.72 |
United Setting Professional Modifier None (both parts) Typical Low $3.98 Median $5.62 Typical High $9.12 | Professional | None (both parts) | $3.98 | $5.62 | $9.12 |
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 $2.29 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3.63 Median $4.27 Typical High $4.27 | Professional | 26 · Professional part | $3.63 | $4.27 | $4.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $13.49 Median $16.22 Typical High $16.22 | Professional | 50 · Both sides | $13.49 | $16.22 | $16.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $5.37 Typical High $5.37 | Professional | 51 · Multiple procedures | $4.47 | $5.37 | $5.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.82 Median $2.14 Typical High $2.14 | Professional | 80 · Assistant surgeon | $1.82 | $2.14 | $2.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.26 Median $1.51 Typical High $1.51 | Professional | 81 · Minimal assistant surgeon | $1.26 | $1.51 | $1.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.26 Median $1.51 Typical High $1.51 | Professional | 82 · Assistant surgeon, no resident | $1.26 | $1.51 | $1.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.26 Median $1.51 Typical High $1.51 | Professional | AS · PA/NP assist | $1.26 | $1.51 | $1.51 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | SH · Second concurrent infusion | $5.37 | $5.37 | $5.37 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | SJ · Third+ concurrent infusion | $5.37 | $5.37 | $5.37 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | TC · Technical part | $5.37 | $6.46 | $6.46 |
Where North Carolina sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 21st of 51
$8.91
NY $126HI $3.16
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.