How much rates vary
Facilitymedian $263 · 10th to 90th $132 to $372Professionalmedian $324 · 10th to 90th $200 to $372
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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $371.54 Typical High $371.54 | Professional | None (both parts) | $199.53 | $371.54 | $371.54 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None (both parts) | $389.05 | $389.05 | $389.05 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $316.23 Median $323.59 Typical High $354.81 | Professional | None (both parts) | $316.23 | $323.59 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $194.98 | $263.03 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $275.42 | Professional | None | $213.80 | $229.09 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $229.09 Typical High $407.38 | Facility | None | $131.83 | $229.09 | $407.38 |
Medcost Setting Professional Modifier None (both parts) Typical Low $234.42 Median $295.12 Typical High $501.19 | Professional | None (both parts) | $234.42 | $295.12 | $501.19 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None (both parts) Typical Low $158.49 Median $208.93 Typical High $295.12 | Professional | None (both parts) | $158.49 | $208.93 | $295.12 |
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 $107.15 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $107.15 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $42.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.38 | $37.15 | $37.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $117.49 Median $125.89 Typical High $281.84 | Professional | 26 · Professional part | $117.49 | $125.89 | $281.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $446.68 Typical High $1,412.54 | Professional | 50 · Both sides | $354.81 | $446.68 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $147.91 Typical High $478.63 | Professional | 51 · Multiple procedures | $117.49 | $147.91 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $58.88 Typical High $190.55 | Professional | 80 · Assistant surgeon | $47.86 | $58.88 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $41.69 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $33.11 | $41.69 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $41.69 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $41.69 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $41.69 Typical High $131.83 | Professional | AS · PA/NP assist | $33.11 | $41.69 | $131.83 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | SH · Second concurrent infusion | $117.49 | $117.49 | $117.49 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | SJ · Third+ concurrent infusion | $117.49 | $117.49 | $117.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $177.83 Median $190.55 Typical High $426.58 | Professional | TC · Technical part | $177.83 | $190.55 | $426.58 |
Where North Carolina sits
The same service costs 4.7 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
$324
HI $912DE $195
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.