How much rates vary
Facilitymedian $50 · 10th to 90th $25 to $51Professionalmedian $35 · 10th to 90th $30 to $50
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $29.51 | $48.98 | $48.98 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $33.88 Median $35.48 Typical High $42.66 | Professional | None (both parts) | $33.88 | $35.48 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $36.31 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $36.31 | $50.12 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $48.98 Typical High $58.88 | Facility | None | $25.12 | $48.98 | $58.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $48.98 Median $58.88 Typical High $74.13 | Professional | None (both parts) | $48.98 | $58.88 | $74.13 |
United Setting Professional Modifier None (both parts) Typical Low $20.42 Median $30.90 Typical High $45.71 | Professional | None (both parts) | $20.42 | $30.90 | $45.71 |
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 $14.79 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $14.79 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $5.89 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $4.47 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.95 | $4.90 | $4.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $23.44 Typical High $36.31 | Professional | 26 · Professional part | $19.50 | $23.44 | $36.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $89.13 Typical High $173.78 | Professional | 50 · Both sides | $72.44 | $89.13 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $29.51 Typical High $58.88 | Professional | 51 · Multiple procedures | $24.55 | $29.51 | $58.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.77 Median $11.75 Typical High $23.44 | Professional | 80 · Assistant surgeon | $9.77 | $11.75 | $23.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.76 Median $8.32 Typical High $16.22 | Professional | 81 · Minimal assistant surgeon | $6.76 | $8.32 | $16.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.76 Median $8.32 Typical High $16.22 | Professional | 82 · Assistant surgeon, no resident | $6.76 | $8.32 | $16.22 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.76 Median $8.32 Typical High $16.22 | Professional | AS · PA/NP assist | $6.76 | $8.32 | $16.22 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | SH · Second concurrent infusion | $29.51 | $29.51 | $29.51 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | SJ · Third+ concurrent infusion | $29.51 | $29.51 | $29.51 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $35.48 Typical High $52.48 | Professional | TC · Technical part | $29.51 | $35.48 | $52.48 |
Where North Carolina sits
The same service costs 4.1 times more in Kansas 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· 49th of 51
$35.48
KS $135CO $33.11
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.