How much rates vary
Facilitymedian $107 · 10th to 90th $55 to $170Professionalmedian $148 · 10th to 90th $89 to $170
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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $95.50 Median $169.82 Typical High $169.82 | Professional | None (both parts) | $95.50 | $169.82 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $190.55 | Facility | None | $158.49 | $158.49 | $190.55 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | None (both parts) | $128.82 | $147.91 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $79.43 | $107.15 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $125.89 | Professional | None | $91.20 | $97.72 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $169.82 Typical High $199.53 | Facility | None | $54.95 | $169.82 | $199.53 |
Medcost Setting Professional Modifier None (both parts) Typical Low $112.20 Median $141.25 Typical High $234.42 | Professional | None (both parts) | $112.20 | $141.25 | $234.42 |
United Setting Professional Modifier None (both parts) Typical Low $66.07 Median $95.50 Typical High $128.82 | Professional | None (both parts) | $66.07 | $95.50 | $128.82 |
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 $47.86 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $47.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $19.05 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $14.45 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.55 | $16.98 | $16.98 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $56.23 Median $58.88 Typical High $131.83 | Professional | 26 · Professional part | $56.23 | $58.88 | $131.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $213.80 Typical High $660.69 | Professional | 50 · Both sides | $169.82 | $213.80 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $70.79 Typical High $218.78 | Professional | 51 · Multiple procedures | $56.23 | $70.79 | $218.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.39 Median $28.18 Typical High $87.10 | Professional | 80 · Assistant surgeon | $22.39 | $28.18 | $87.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $19.95 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $15.85 | $19.95 | $61.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $19.95 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $19.95 | $61.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $19.95 Typical High $61.66 | Professional | AS · PA/NP assist | $15.85 | $19.95 | $61.66 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | SH · Second concurrent infusion | $56.23 | $56.23 | $56.23 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | SJ · Third+ concurrent infusion | $56.23 | $56.23 | $56.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $85.11 Median $87.10 Typical High $194.98 | Professional | TC · Technical part | $85.11 | $87.10 | $194.98 |
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· 17th of 51
$148
MT $204DE $79.43
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.