How much rates vary
Facilitymedian $28 · 10th to 90th $13 to $28Professionalmedian $19 · 10th to 90th $15 to $28
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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $25.70 Typical High $25.70 | Professional | None (both parts) | $15.49 | $25.70 | $25.70 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $17.78 Median $18.62 Typical High $19.95 | Professional | None (both parts) | $17.78 | $18.62 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $27.54 Typical High $27.54 | Professional | None (both parts) | $19.95 | $27.54 | $27.54 |
Medcost Setting Facility Modifier None Typical Low $13.18 Median $25.70 Typical High $30.90 | Facility | None | $13.18 | $25.70 | $30.90 |
Medcost Setting Professional Modifier None (both parts) Typical Low $25.70 Median $30.90 Typical High $38.90 | Professional | None (both parts) | $25.70 | $30.90 | $38.90 |
United Setting Professional Modifier None (both parts) Typical Low $10.72 Median $16.22 Typical High $23.99 | Professional | None (both parts) | $10.72 | $16.22 | $23.99 |
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 $7.76 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $7.76 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $3.09 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $2.34 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.55 | $2.57 | $2.57 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.23 Median $12.30 Typical High $19.05 | Professional | 26 · Professional part | $10.23 | $12.30 | $19.05 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $38.90 Median $46.77 Typical High $93.33 | Professional | 50 · Both sides | $38.90 | $46.77 | $93.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $15.49 Typical High $30.90 | Professional | 51 · Multiple procedures | $12.88 | $15.49 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.13 Median $6.17 Typical High $12.30 | Professional | 80 · Assistant surgeon | $5.13 | $6.17 | $12.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $4.37 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $3.63 | $4.37 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $4.37 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $4.37 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $4.37 Typical High $8.71 | Professional | AS · PA/NP assist | $3.63 | $4.37 | $8.71 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | SH · Second concurrent infusion | $15.49 | $15.49 | $15.49 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | SJ · Third+ concurrent infusion | $15.49 | $15.49 | $15.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $15.49 Median $18.62 Typical High $27.54 | Professional | TC · Technical part | $15.49 | $18.62 | $27.54 |
Where North Carolina sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 47th of 51
$18.62
WY $75.86CO $17.38
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.