How much rates vary
Facilitymedian $347 · 10th to 90th $162 to $372Professionalmedian $380 · 10th to 90th $245 to $427
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 $281.84 Median $371.54 Typical High $371.54 | Professional | None (both parts) | $281.84 | $371.54 | $371.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $288.40 Median $380.19 Typical High $512.86 | Professional | None (both parts) | $288.40 | $380.19 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | None (both parts) | $251.19 | $346.74 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $426.58 | Professional | None | $309.03 | $338.84 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $275.42 Typical High $407.38 | Facility | None | $162.18 | $275.42 | $407.38 |
Medcost Setting Professional Modifier None (both parts) Typical Low $281.84 Median $354.81 Typical High $602.56 | Professional | None (both parts) | $281.84 | $354.81 | $602.56 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Facility | None | $173.78 | $173.78 | $251.19 |
United Setting Professional Modifier None (both parts) Typical Low $190.55 Median $251.19 Typical High $380.19 | Professional | None (both parts) | $190.55 | $251.19 | $380.19 |
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 $141.25 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $141.25 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $56.23 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $28.18 | $37.15 | $37.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $141.25 Median $151.36 Typical High $338.84 | Professional | 26 · Professional part | $141.25 | $151.36 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $524.81 Typical High $1,698.24 | Professional | 50 · Both sides | $426.58 | $524.81 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $177.83 Typical High $562.34 | Professional | 51 · Multiple procedures | $141.25 | $177.83 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $70.79 Typical High $223.87 | Professional | 80 · Assistant surgeon | $56.23 | $70.79 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $48.98 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $39.81 | $48.98 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $48.98 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $48.98 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $48.98 Typical High $158.49 | Professional | AS · PA/NP assist | $39.81 | $48.98 | $158.49 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | SH · Second concurrent infusion | $141.25 | $141.25 | $141.25 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | SJ · Third+ concurrent infusion | $141.25 | $141.25 | $141.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $208.93 Median $223.87 Typical High $501.19 | Professional | TC · Technical part | $208.93 | $223.87 | $501.19 |
Where North Carolina sits
The same service costs 2.9 times more in Iowa than in Kansas. 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
$380
IA $603KS $209
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.