How much rates vary
Facilitymedian $34 · 10th to 90th $18 to $54Professionalmedian $47 · 10th to 90th $28 to $54
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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $53.70 Typical High $53.70 | Professional | None (both parts) | $29.51 | $53.70 | $53.70 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $46.77 Typical High $50.12 | Professional | None (both parts) | $40.74 | $46.77 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $33.88 Typical High $35.48 | Professional | None (both parts) | $25.12 | $33.88 | $35.48 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $39.81 | Professional | None | $28.84 | $30.90 | $39.81 |
Medcost Setting Facility Modifier None Typical Low $17.78 Median $53.70 Typical High $63.10 | Facility | None | $17.78 | $53.70 | $63.10 |
Medcost Setting Professional Modifier None (both parts) Typical Low $36.31 Median $44.67 Typical High $74.13 | Professional | None (both parts) | $36.31 | $44.67 | $74.13 |
United Setting Professional Modifier None (both parts) Typical Low $20.89 Median $30.20 Typical High $40.74 | Professional | None (both parts) | $20.89 | $30.20 | $40.74 |
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 $15.14 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $15.14 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $6.17 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $4.57 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.02 | $5.37 | $5.37 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $18.62 Typical High $41.69 | Professional | 26 · Professional part | $18.20 | $18.62 | $41.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $67.61 Typical High $208.93 | Professional | 50 · Both sides | $53.70 | $67.61 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.20 Median $22.39 Typical High $69.18 | Professional | 51 · Multiple procedures | $18.20 | $22.39 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.24 Median $8.91 Typical High $27.54 | Professional | 80 · Assistant surgeon | $7.24 | $8.91 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.01 Median $6.31 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $5.01 | $6.31 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.01 Median $6.31 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $5.01 | $6.31 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $6.31 Typical High $19.50 | Professional | AS · PA/NP assist | $5.01 | $6.31 | $19.50 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | SH · Second concurrent infusion | $18.20 | $18.20 | $18.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | SJ · Third+ concurrent infusion | $18.20 | $18.20 | $18.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $27.54 Typical High $61.66 | Professional | TC · Technical part | $26.92 | $27.54 | $61.66 |
Where North Carolina sits
The same service costs 2.8 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
$46.77
MT $64.57KS $23.44
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.