How much rates vary
Facilitymedian $66 · 10th to 90th $33 to $93Professionalmedian $81 · 10th to 90th $49 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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $52.48 | $93.33 | $93.33 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $61.66 Median $81.28 Typical High $109.65 | Professional | None (both parts) | $61.66 | $81.28 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $48.98 | $66.07 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $69.18 | Professional | None | $60.26 | $64.57 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $33.11 Median $57.54 Typical High $102.33 | Facility | None | $33.11 | $57.54 | $102.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $60.26 Median $75.86 Typical High $128.82 | Professional | None (both parts) | $60.26 | $75.86 | $128.82 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $61.66 | Facility | None | $46.77 | $46.77 | $61.66 |
United Setting Professional Modifier None (both parts) Typical Low $38.90 Median $52.48 Typical High $72.44 | Professional | None (both parts) | $38.90 | $52.48 | $72.44 |
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 $26.30 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $10.47 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $7.94 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.25 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $32.36 Typical High $70.79 | Professional | 26 · Professional part | $30.20 | $32.36 | $70.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $112.20 Typical High $363.08 | Professional | 50 · Both sides | $89.13 | $112.20 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $37.15 Typical High $120.23 | Professional | 51 · Multiple procedures | $30.20 | $37.15 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $15.14 Typical High $47.86 | Professional | 80 · Assistant surgeon | $12.02 | $15.14 | $47.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $10.47 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $8.32 | $10.47 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $10.47 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $10.47 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $10.47 Typical High $33.88 | Professional | AS · PA/NP assist | $8.32 | $10.47 | $33.88 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | SH · Second concurrent infusion | $30.20 | $30.20 | $30.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | SJ · Third+ concurrent infusion | $30.20 | $30.20 | $30.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $47.86 Typical High $107.15 | Professional | TC · Technical part | $44.67 | $47.86 | $107.15 |
Where North Carolina sits
The same service costs 2.7 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· 18th of 51
$81.28
HI $132DE $48.98
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.