How much rates vary
Facilitymedian $71 · 10th to 90th $62 to $83Professionalmedian $74 · 10th to 90th $48 to $93
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $52.48 | $83.18 | $83.18 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $50.12 Median $63.10 Typical High $93.33 | Professional | None (both parts) | $50.12 | $63.10 | $93.33 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | None (both parts) | $72.44 | $74.13 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $61.66 Typical High $67.61 | Professional | None (both parts) | $44.67 | $61.66 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $95.50 | Facility | None | $70.79 | $75.86 | $95.50 |
Medcost Setting Professional Modifier None (both parts) Typical Low $75.86 Median $77.62 Typical High $120.23 | Professional | None (both parts) | $75.86 | $77.62 | $120.23 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None (both parts) Typical Low $37.15 Median $47.86 Typical High $67.61 | Professional | None (both parts) | $37.15 | $47.86 | $67.61 |
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 $25.70 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $25.70 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $10.23 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $7.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.13 | $8.32 | $8.32 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $38.02 Typical High $64.57 | Professional | 26 · Professional part | $30.20 | $38.02 | $64.57 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $117.49 Typical High $323.59 | Professional | 50 · Both sides | $112.20 | $117.49 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $38.90 Typical High $107.15 | Professional | 51 · Multiple procedures | $37.15 | $38.90 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $15.49 Typical High $43.65 | Professional | 80 · Assistant surgeon | $15.14 | $15.49 | $43.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $10.96 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $10.47 | $10.96 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $10.96 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $10.96 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $10.96 Typical High $30.20 | Professional | AS · PA/NP assist | $10.47 | $10.96 | $30.20 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | SH · Second concurrent infusion | $38.90 | $38.90 | $38.90 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | SJ · Third+ concurrent infusion | $38.90 | $38.90 | $38.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $57.54 Typical High $97.72 | Professional | TC · Technical part | $44.67 | $57.54 | $97.72 |
Where North Carolina sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 22nd of 51
$74.13
WI $100NJ $47.86
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.