How much rates vary
Facilitymedian $355 · 10th to 90th $148 to $398Professionalmedian $355 · 10th to 90th $219 to $398
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $229.09 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $229.09 | $398.11 | $398.11 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $269.15 Median $354.81 Typical High $467.74 | Professional | None (both parts) | $269.15 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $257.04 | $354.81 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $309.03 | Professional | None | $223.87 | $239.88 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $446.68 | Facility | None | $147.91 | $251.19 | $446.68 |
Medcost Setting Professional Modifier None (both parts) Typical Low $257.04 Median $323.59 Typical High $549.54 | Professional | None (both parts) | $257.04 | $323.59 | $549.54 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | None | $234.42 | $234.42 | $309.03 |
United Setting Professional Modifier None (both parts) Typical Low $177.83 Median $229.09 Typical High $323.59 | Professional | None (both parts) | $177.83 | $229.09 | $323.59 |
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 $114.82 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $45.71 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $34.67 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.91 | $39.81 | $39.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $128.82 Median $138.04 Typical High $309.03 | Professional | 26 · Professional part | $128.82 | $138.04 | $309.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $489.78 Typical High $1,548.82 | Professional | 50 · Both sides | $389.05 | $489.78 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $162.18 Typical High $524.81 | Professional | 51 · Multiple procedures | $128.82 | $162.18 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | 80 · Assistant surgeon | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $45.71 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $36.31 | $45.71 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $45.71 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $45.71 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $45.71 Typical High $144.54 | Professional | AS · PA/NP assist | $36.31 | $45.71 | $144.54 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | SH · Second concurrent infusion | $128.82 | $128.82 | $128.82 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | SJ · Third+ concurrent infusion | $128.82 | $128.82 | $128.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $194.98 Median $208.93 Typical High $467.74 | Professional | TC · Technical part | $194.98 | $208.93 | $467.74 |
Where North Carolina sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 18th of 51
$355
HI $832FL $240
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.