How much rates vary
Facilitymedian $54 · 10th to 90th $38 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 $48.98 Median $81.28 Typical High $81.28 | Professional | None (both parts) | $48.98 | $81.28 | $81.28 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $69.18 Median $70.79 Typical High $75.86 | Professional | None (both parts) | $69.18 | $70.79 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $53.70 Typical High $53.70 | Professional | None (both parts) | $38.90 | $53.70 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $63.10 Typical High $89.13 | Facility | None | $38.02 | $63.10 | $89.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.90 Median $48.98 Typical High $109.65 | Professional | None (both parts) | $38.90 | $48.98 | $109.65 |
United Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
United Setting Professional Modifier None (both parts) Typical Low $33.88 Median $45.71 Typical High $66.07 | Professional | None (both parts) | $33.88 | $45.71 | $66.07 |
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 $23.44 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $23.44 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $9.33 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $7.08 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.68 | $8.13 | $8.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $28.84 Typical High $61.66 | Professional | 26 · Professional part | $19.50 | $28.84 | $61.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $74.13 Typical High $316.23 | Professional | 50 · Both sides | $58.88 | $74.13 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $24.55 Typical High $104.71 | Professional | 51 · Multiple procedures | $19.50 | $24.55 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.76 Median $9.77 Typical High $41.69 | Professional | 80 · Assistant surgeon | $7.76 | $9.77 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.50 Median $6.92 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $5.50 | $6.92 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.50 Median $6.92 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $5.50 | $6.92 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.50 Median $6.92 Typical High $29.51 | Professional | AS · PA/NP assist | $5.50 | $6.92 | $29.51 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | SH · Second concurrent infusion | $19.50 | $19.50 | $19.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | SJ · Third+ concurrent infusion | $19.50 | $19.50 | $19.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $43.65 Typical High $93.33 | Professional | TC · Technical part | $29.51 | $43.65 | $93.33 |
Where North Carolina sits
The same service costs 3.3 times more in Hawaii 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
$70.79
HI $135DE $40.74
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.