How much rates vary
Facilitymedian $229 · 10th to 90th $110 to $295Professionalmedian $263 · 10th to 90th $166 to $295
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $169.82 | $295.12 | $295.12 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $263.03 | $263.03 | $263.03 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | None (both parts) | $223.87 | $263.03 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $229.09 Typical High $245.47 | Professional | None (both parts) | $165.96 | $229.09 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $234.42 | Professional | None | $190.55 | $204.17 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $186.21 Typical High $331.13 | Facility | None | $109.65 | $186.21 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $190.55 Median $239.88 Typical High $407.38 | Professional | None (both parts) | $190.55 | $239.88 | $407.38 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
United Setting Professional Modifier None (both parts) Typical Low $131.83 Median $169.82 Typical High $239.88 | Professional | None (both parts) | $131.83 | $169.82 | $239.88 |
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 $87.10 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $26.30 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $95.50 Median $102.33 Typical High $229.09 | Professional | 26 · Professional part | $95.50 | $102.33 | $229.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $363.08 Typical High $1,148.15 | Professional | 50 · Both sides | $288.40 | $363.08 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $120.23 Typical High $389.05 | Professional | 51 · Multiple procedures | $95.50 | $120.23 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $47.86 Typical High $154.88 | Professional | 80 · Assistant surgeon | $38.02 | $47.86 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $33.88 Typical High $107.15 | Professional | AS · PA/NP assist | $26.92 | $33.88 | $107.15 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | SH · Second concurrent infusion | $95.50 | $95.50 | $95.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | SJ · Third+ concurrent infusion | $95.50 | $95.50 | $95.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $154.88 Typical High $346.74 | Professional | TC · Technical part | $144.54 | $154.88 | $346.74 |
Where North Carolina sits
The same service costs 3.5 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· 21st of 51
$263
HI $589DE $166
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.