How much rates vary
Facilitymedian $50 · 10th to 90th $26 to $78Professionalmedian $68 · 10th to 90th $41 to $78
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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $41.69 | $77.62 | $77.62 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None (both parts) | $61.66 | $61.66 | $61.66 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $58.88 Median $67.61 Typical High $72.44 | Professional | None (both parts) | $58.88 | $67.61 | $72.44 |
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 Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $57.54 | Professional | None | $41.69 | $44.67 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $77.62 Typical High $91.20 | Facility | None | $25.70 | $77.62 | $91.20 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $64.57 Typical High $107.15 | Professional | None (both parts) | $52.48 | $64.57 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $30.20 Median $43.65 Typical High $58.88 | Professional | None (both parts) | $30.20 | $43.65 | $58.88 |
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 $21.88 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $21.88 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $8.91 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $6.61 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.47 | $7.76 | $7.76 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $20.89 Median $26.92 Typical High $60.26 | Professional | 26 · Professional part | $20.89 | $26.92 | $60.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $97.72 Typical High $302.00 | Professional | 50 · Both sides | $77.62 | $97.72 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.70 Median $32.36 Typical High $100.00 | Professional | 51 · Multiple procedures | $25.70 | $32.36 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $12.88 Typical High $40.74 | Professional | 80 · Assistant surgeon | $10.47 | $12.88 | $40.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.24 Median $9.12 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $7.24 | $9.12 | $28.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.24 Median $9.12 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $7.24 | $9.12 | $28.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.24 Median $9.12 Typical High $28.18 | Professional | AS · PA/NP assist | $7.24 | $9.12 | $28.18 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SH · Second concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SJ · Third+ concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $40.74 Typical High $89.13 | Professional | TC · Technical part | $30.90 | $40.74 | $89.13 |
Where North Carolina sits
The same service costs 3.0 times more in Hawaii 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· 15th of 51
$67.61
HI $89.13KS $30.20
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.