How much rates vary
Facilitymedian $25 · 10th to 90th $10 to $31Professionalmedian $27 · 10th to 90th $17 to $31
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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $17.38 Median $30.90 Typical High $30.90 | Professional | None (both parts) | $17.38 | $30.90 | $30.90 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $26.92 Typical High $28.84 | Professional | None (both parts) | $23.44 | $26.92 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $17.78 Median $24.55 Typical High $24.55 | Professional | None (both parts) | $17.78 | $24.55 | $24.55 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $22.91 | Professional | None | $16.60 | $17.78 | $22.91 |
Medcost Setting Facility Modifier None Typical Low $10.23 Median $30.90 Typical High $36.31 | Facility | None | $10.23 | $30.90 | $36.31 |
Medcost Setting Professional Modifier None (both parts) Typical Low $19.95 Median $25.12 Typical High $42.66 | Professional | None (both parts) | $19.95 | $25.12 | $42.66 |
United Setting Professional Modifier None (both parts) Typical Low $12.02 Median $17.38 Typical High $23.44 | Professional | None (both parts) | $12.02 | $17.38 | $23.44 |
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 $8.71 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $8.71 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $3.55 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $2.63 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.78 | $3.09 | $3.09 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $10.72 Typical High $23.99 | Professional | 26 · Professional part | $7.94 | $10.72 | $23.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $30.20 Median $37.15 Typical High $120.23 | Professional | 50 · Both sides | $30.20 | $37.15 | $120.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.00 Median $12.30 Typical High $39.81 | Professional | 51 · Multiple procedures | $10.00 | $12.30 | $39.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.98 Median $5.01 Typical High $15.85 | Professional | 80 · Assistant surgeon | $3.98 | $5.01 | $15.85 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.82 Median $3.47 Typical High $11.22 | Professional | 81 · Minimal assistant surgeon | $2.82 | $3.47 | $11.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.82 Median $3.47 Typical High $11.22 | Professional | 82 · Assistant surgeon, no resident | $2.82 | $3.47 | $11.22 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.82 Median $3.47 Typical High $11.22 | Professional | AS · PA/NP assist | $2.82 | $3.47 | $11.22 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | SH · Second concurrent infusion | $10.96 | $10.96 | $10.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | SJ · Third+ concurrent infusion | $10.96 | $10.96 | $10.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $12.02 Median $15.85 Typical High $35.48 | Professional | TC · Technical part | $12.02 | $15.85 | $35.48 |
Where North Carolina sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$26.92
MT $37.15WV $17.78
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.