How much rates vary
Facilitymedian $71 · 10th to 90th $51 to $102Professionalmedian $89 · 10th to 90th $52 to $102
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $57.54 Median $102.33 Typical High $102.33 | Professional | None (both parts) | $57.54 | $102.33 | $102.33 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $87.10 Median $89.13 Typical High $95.50 | Professional | None (both parts) | $87.10 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $51.29 | $70.79 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $75.86 Typical High $112.20 | Facility | None | $51.29 | $75.86 | $112.20 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $67.61 Typical High $138.04 | Professional | None (both parts) | $52.48 | $67.61 | $138.04 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None (both parts) Typical Low $40.74 Median $57.54 Typical High $81.28 | Professional | None (both parts) | $40.74 | $57.54 | $81.28 |
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 $28.84 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $28.84 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $18.20 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $10.23 | $10.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $36.31 Typical High $77.62 | Professional | 26 · Professional part | $26.92 | $36.31 | $77.62 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $100.00 Typical High $398.11 | Professional | 50 · Both sides | $79.43 | $100.00 | $398.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $33.88 Typical High $131.83 | Professional | 51 · Multiple procedures | $26.30 | $33.88 | $131.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $52.48 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $52.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $9.33 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $7.41 | $9.33 | $37.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $9.33 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $9.33 | $37.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $9.33 Typical High $37.15 | Professional | AS · PA/NP assist | $7.41 | $9.33 | $37.15 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SH · Second concurrent infusion | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SJ · Third+ concurrent infusion | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $54.95 Typical High $117.49 | Professional | TC · Technical part | $39.81 | $54.95 | $117.49 |
Where North Carolina sits
The same service costs 2.4 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· 15th of 51
$89.13
MT $123DE $51.29
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.