How much rates vary
Facilitymedian $27 · 10th to 90th $13 to $41Professionalmedian $35 · 10th to 90th $21 to $41
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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $22.91 | $40.74 | $40.74 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $35.48 Typical High $38.02 | Professional | None (both parts) | $30.20 | $35.48 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $26.92 Typical High $26.92 | Professional | None (both parts) | $19.95 | $26.92 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $30.20 | Professional | None | $21.38 | $22.91 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $13.18 Median $40.74 Typical High $46.77 | Facility | None | $13.18 | $40.74 | $46.77 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.92 Median $33.88 Typical High $54.95 | Professional | None (both parts) | $26.92 | $33.88 | $54.95 |
United Setting Professional Modifier None (both parts) Typical Low $15.85 Median $22.91 Typical High $30.90 | Professional | None (both parts) | $15.85 | $22.91 | $30.90 |
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 $11.48 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $11.48 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $4.57 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $3.47 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.29 | $4.07 | $4.07 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $13.49 Median $13.80 Typical High $30.90 | Professional | 26 · Professional part | $13.49 | $13.80 | $30.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $40.74 Median $51.29 Typical High $154.88 | Professional | 50 · Both sides | $40.74 | $51.29 | $154.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $16.98 Typical High $52.48 | Professional | 51 · Multiple procedures | $13.49 | $16.98 | $52.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $6.76 Typical High $20.89 | Professional | 80 · Assistant surgeon | $5.37 | $6.76 | $20.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $4.79 Typical High $14.45 | Professional | 81 · Minimal assistant surgeon | $3.80 | $4.79 | $14.45 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $4.79 Typical High $14.45 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $4.79 | $14.45 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $4.79 Typical High $14.45 | Professional | AS · PA/NP assist | $3.80 | $4.79 | $14.45 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | SH · Second concurrent infusion | $13.49 | $13.49 | $13.49 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | SJ · Third+ concurrent infusion | $13.49 | $13.49 | $13.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $20.89 Typical High $46.77 | Professional | TC · Technical part | $20.42 | $20.89 | $46.77 |
Where North Carolina sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$35.48
MT $48.98DE $19.95
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.