How much rates vary
Facilitymedian $29 · 10th to 90th $14 to $30Professionalmedian $20 · 10th to 90th $17 to $29
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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $16.60 Median $27.54 Typical High $27.54 | Professional | None (both parts) | $16.60 | $27.54 | $27.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $19.05 Median $19.95 Typical High $26.30 | Professional | None (both parts) | $19.05 | $19.95 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $20.89 Median $28.84 Typical High $28.84 | Professional | None (both parts) | $20.89 | $28.84 | $28.84 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $27.54 Typical High $33.11 | Facility | None | $14.13 | $27.54 | $33.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.92 Median $33.11 Typical High $40.74 | Professional | None (both parts) | $26.92 | $33.11 | $40.74 |
United Setting Professional Modifier None (both parts) Typical Low $11.48 Median $16.98 Typical High $25.70 | Professional | None (both parts) | $11.48 | $16.98 | $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 $8.32 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $8.32 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $3.31 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $2.45 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $1.66 | $2.75 | $2.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $13.18 Typical High $20.42 | Professional | 26 · Professional part | $10.72 | $13.18 | $20.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $40.74 Median $48.98 Typical High $97.72 | Professional | 50 · Both sides | $40.74 | $48.98 | $97.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $16.60 Typical High $32.36 | Professional | 51 · Multiple procedures | $13.49 | $16.60 | $32.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $6.61 Typical High $13.18 | Professional | 80 · Assistant surgeon | $5.37 | $6.61 | $13.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $4.57 Typical High $9.12 | Professional | 81 · Minimal assistant surgeon | $3.80 | $4.57 | $9.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $4.57 Typical High $9.12 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $4.57 | $9.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $4.57 Typical High $9.12 | Professional | AS · PA/NP assist | $3.80 | $4.57 | $9.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | SH · Second concurrent infusion | $16.60 | $16.60 | $16.60 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | SJ · Third+ concurrent infusion | $16.60 | $16.60 | $16.60 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.22 Median $19.50 Typical High $28.84 | Professional | TC · Technical part | $16.22 | $19.50 | $28.84 |
Where North Carolina sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 48th of 51
$19.95
WY $75.86UT $18.62
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.