How much rates vary
Facilitymedian $51 · 10th to 90th $26 to $81Professionalmedian $71 · 10th to 90th $43 to $81
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $81.28 Typical High $81.28 | Professional | None (both parts) | $45.71 | $81.28 | $81.28 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | None (both parts) | $60.26 | $70.79 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $37.15 | $51.29 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $60.26 | Professional | None | $42.66 | $46.77 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $26.30 Median $81.28 Typical High $93.33 | Facility | None | $26.30 | $81.28 | $93.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $57.54 Median $67.61 Typical High $112.20 | Professional | None (both parts) | $57.54 | $67.61 | $112.20 |
United Setting Professional Modifier None (both parts) Typical Low $31.62 Median $45.71 Typical High $61.66 | Professional | None (both parts) | $31.62 | $45.71 | $61.66 |
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 $22.91 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $22.91 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $9.12 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $6.92 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.57 | $8.13 | $8.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $27.54 Typical High $61.66 | Professional | 26 · Professional part | $26.92 | $27.54 | $61.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $100.00 Typical High $316.23 | Professional | 50 · Both sides | $87.10 | $100.00 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.84 Median $33.88 Typical High $104.71 | Professional | 51 · Multiple procedures | $28.84 | $33.88 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $13.49 Typical High $41.69 | Professional | 80 · Assistant surgeon | $11.48 | $13.49 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.13 Median $9.33 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $8.13 | $9.33 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.13 Median $9.33 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $8.13 | $9.33 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.13 Median $9.33 Typical High $29.51 | Professional | AS · PA/NP assist | $8.13 | $9.33 | $29.51 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | SH · Second concurrent infusion | $28.84 | $28.84 | $28.84 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | SJ · Third+ concurrent infusion | $28.84 | $28.84 | $28.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $41.69 Typical High $93.33 | Professional | TC · Technical part | $39.81 | $41.69 | $93.33 |
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
$70.79
MT $97.72DE $37.15
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.