How much rates vary
Facilitymedian $33 · 10th to 90th $17 to $52Professionalmedian $46 · 10th to 90th $28 to $52
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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $29.51 | $52.48 | $52.48 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $43.65 Median $45.71 Typical High $48.98 | Professional | None (both parts) | $43.65 | $45.71 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $24.55 | $33.11 | $33.11 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $38.90 | Professional | None | $28.18 | $30.20 | $38.90 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $52.48 Typical High $61.66 | Facility | None | $17.38 | $52.48 | $61.66 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.02 Median $43.65 Typical High $72.44 | Professional | None (both parts) | $38.02 | $43.65 | $72.44 |
United Setting Professional Modifier None (both parts) Typical Low $20.42 Median $29.51 Typical High $39.81 | Professional | None (both parts) | $20.42 | $29.51 | $39.81 |
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 $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $14.79 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $5.89 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $4.47 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.95 | $5.25 | $5.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $18.20 Typical High $40.74 | Professional | 26 · Professional part | $17.78 | $18.20 | $40.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $66.07 Typical High $204.17 | Professional | 50 · Both sides | $57.54 | $66.07 | $204.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $21.88 Typical High $67.61 | Professional | 51 · Multiple procedures | $19.05 | $21.88 | $67.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $8.71 Typical High $26.92 | Professional | 80 · Assistant surgeon | $7.59 | $8.71 | $26.92 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $6.17 Typical High $19.05 | Professional | 81 · Minimal assistant surgeon | $5.37 | $6.17 | $19.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $6.17 Typical High $19.05 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $6.17 | $19.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $6.17 Typical High $19.05 | Professional | AS · PA/NP assist | $5.37 | $6.17 | $19.05 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | SH · Second concurrent infusion | $19.05 | $19.05 | $19.05 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | SJ · Third+ concurrent infusion | $19.05 | $19.05 | $19.05 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.30 Median $26.92 Typical High $60.26 | Professional | TC · Technical part | $26.30 | $26.92 | $60.26 |
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
$45.71
MT $63.10DE $24.55
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.