How much rates vary
Facilitymedian $112 · 10th to 90th $58 to $178Professionalmedian $155 · 10th to 90th $93 to $178
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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $177.83 Typical High $177.83 | Professional | None (both parts) | $100.00 | $177.83 | $177.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $154.88 Typical High $165.96 | Professional | None (both parts) | $134.90 | $154.88 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $83.18 | $112.20 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $131.83 | Professional | None | $95.50 | $102.33 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $112.20 Typical High $194.98 | Facility | None | $57.54 | $112.20 | $194.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $114.82 Median $144.54 Typical High $245.47 | Professional | None (both parts) | $114.82 | $144.54 | $245.47 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None (both parts) Typical Low $69.18 Median $100.00 Typical High $134.90 | Professional | None (both parts) | $69.18 | $100.00 | $134.90 |
15 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 $50.12 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $50.12 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $19.95 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.00 | $17.78 | $17.78 |
Cigna Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $61.66 Typical High $138.04 | Professional | 26 · Professional part | $57.54 | $61.66 | $138.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $213.80 Typical High $691.83 | Professional | 50 · Both sides | $169.82 | $213.80 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $70.79 Typical High $229.09 | Professional | 51 · Multiple procedures | $57.54 | $70.79 | $229.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $28.84 Typical High $91.20 | Professional | 80 · Assistant surgeon | $22.91 | $28.84 | $91.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $19.95 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $15.85 | $19.95 | $64.57 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $19.95 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $19.95 | $64.57 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $19.95 Typical High $64.57 | Professional | AS · PA/NP assist | $15.85 | $19.95 | $64.57 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | SH · Second concurrent infusion | $57.54 | $57.54 | $57.54 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | SJ · Third+ concurrent infusion | $57.54 | $57.54 | $57.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $85.11 Median $91.20 Typical High $204.17 | Professional | TC · Technical part | $85.11 | $91.20 | $204.17 |
Where North Carolina sits
The same service costs 2.3 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· 16th of 51
$155
HI $200DE $85.11
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.