How much rates vary
Facilitymedian $58 · 10th to 90th $30 to $91Professionalmedian $79 · 10th to 90th $48 to $91
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $91.20 Typical High $91.20 | Professional | None (both parts) | $51.29 | $91.20 | $91.20 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $67.61 Median $79.43 Typical High $85.11 | Professional | None (both parts) | $67.61 | $79.43 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $57.54 Typical High $57.54 | Professional | None (both parts) | $41.69 | $57.54 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $67.61 | Professional | None | $47.86 | $51.29 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $91.20 Typical High $104.71 | Facility | None | $29.51 | $91.20 | $104.71 |
Medcost Setting Professional Modifier None (both parts) Typical Low $58.88 Median $75.86 Typical High $123.03 | Professional | None (both parts) | $58.88 | $75.86 | $123.03 |
United Setting Professional Modifier None (both parts) Typical Low $35.48 Median $51.29 Typical High $69.18 | Professional | None (both parts) | $35.48 | $51.29 | $69.18 |
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 $25.70 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $25.70 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $10.23 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $7.59 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.13 | $9.12 | $9.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $30.90 Typical High $69.18 | Professional | 26 · Professional part | $30.20 | $30.90 | $69.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $112.20 Typical High $346.74 | Professional | 50 · Both sides | $89.13 | $112.20 | $346.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $29.51 Median $37.15 Typical High $117.49 | Professional | 51 · Multiple procedures | $29.51 | $37.15 | $117.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.75 Median $15.14 Typical High $46.77 | Professional | 80 · Assistant surgeon | $11.75 | $15.14 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $10.47 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $8.32 | $10.47 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $10.47 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $10.47 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $10.47 Typical High $32.36 | Professional | AS · PA/NP assist | $8.32 | $10.47 | $32.36 |
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 $44.67 Median $46.77 Typical High $104.71 | Professional | TC · Technical part | $44.67 | $46.77 | $104.71 |
Where North Carolina sits
The same service costs 2.6 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· 16th of 51
$79.43
MT $110DE $41.69
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.