How much rates vary
Facilitymedian $16 · 10th to 90th $8 to $25Professionalmedian $22 · 10th to 90th $13 to $25
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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $14.13 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $14.13 | $25.12 | $25.12 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $18.62 Median $21.88 Typical High $23.44 | Professional | None (both parts) | $18.62 | $21.88 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None (both parts) Typical Low $11.48 Median $15.85 Typical High $15.85 | Professional | None (both parts) | $11.48 | $15.85 | $15.85 |
Medcost Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $18.62 | Professional | None | $13.18 | $14.45 | $18.62 |
Medcost Setting Facility Modifier None Typical Low $8.13 Median $15.49 Typical High $27.54 | Facility | None | $8.13 | $15.49 | $27.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $15.85 Median $20.89 Typical High $33.88 | Professional | None (both parts) | $15.85 | $20.89 | $33.88 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None (both parts) Typical Low $9.77 Median $14.13 Typical High $19.05 | Professional | None (both parts) | $9.77 | $14.13 | $19.05 |
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 $7.08 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $7.08 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $2.82 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $2.14 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.41 | $2.51 | $2.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $8.32 Median $8.51 Typical High $19.05 | Professional | 26 · Professional part | $8.32 | $8.51 | $19.05 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $23.99 Median $31.62 Typical High $97.72 | Professional | 50 · Both sides | $23.99 | $31.62 | $97.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.94 Median $10.47 Typical High $32.36 | Professional | 51 · Multiple procedures | $7.94 | $10.47 | $32.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.24 Median $4.17 Typical High $12.88 | Professional | 80 · Assistant surgeon | $3.24 | $4.17 | $12.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.24 Median $2.95 Typical High $9.12 | Professional | 81 · Minimal assistant surgeon | $2.24 | $2.95 | $9.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.24 Median $2.95 Typical High $9.12 | Professional | 82 · Assistant surgeon, no resident | $2.24 | $2.95 | $9.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.24 Median $2.95 Typical High $9.12 | Professional | AS · PA/NP assist | $2.24 | $2.95 | $9.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | SH · Second concurrent infusion | $7.94 | $7.94 | $7.94 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | SJ · Third+ concurrent infusion | $7.94 | $7.94 | $7.94 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $12.59 Median $12.88 Typical High $28.84 | Professional | TC · Technical part | $12.59 | $12.88 | $28.84 |
Where North Carolina sits
The same service costs 5.5 times more in Kansas 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
$21.88
KS $63.10DE $11.48
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.