How much rates vary
Facilitymedian $245 · 10th to 90th $123 to $282Professionalmedian $295 · 10th to 90th $182 to $324
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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $194.98 | $281.84 | $281.84 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $295.12 | $295.12 | $295.12 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $223.87 Median $295.12 Typical High $389.05 | Professional | None (both parts) | $223.87 | $295.12 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | None (both parts) | $181.97 | $245.47 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $331.13 | Professional | None | $234.42 | $257.04 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $309.03 | Facility | None | $123.03 | $208.93 | $309.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $213.80 Median $269.15 Typical High $457.09 | Professional | None (both parts) | $213.80 | $269.15 | $457.09 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | None | $190.55 | $190.55 | $245.47 |
United Setting Professional Modifier None (both parts) Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | None (both parts) | $144.54 | $190.55 | $288.40 |
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 $120.23 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $28.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $107.15 Median $114.82 Typical High $257.04 | Professional | 26 · Professional part | $107.15 | $114.82 | $257.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $398.11 Typical High $1,288.25 | Professional | 50 · Both sides | $323.59 | $398.11 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $134.90 Typical High $426.58 | Professional | 51 · Multiple procedures | $107.15 | $134.90 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $53.70 Typical High $173.78 | Professional | 80 · Assistant surgeon | $42.66 | $53.70 | $173.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $37.15 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $30.20 | $37.15 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $37.15 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $37.15 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $37.15 Typical High $120.23 | Professional | AS · PA/NP assist | $30.20 | $37.15 | $120.23 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | SH · Second concurrent infusion | $107.15 | $107.15 | $107.15 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | SJ · Third+ concurrent infusion | $107.15 | $107.15 | $107.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $162.18 Median $173.78 Typical High $380.19 | Professional | TC · Technical part | $162.18 | $173.78 | $380.19 |
Where North Carolina sits
The same service costs 2.5 times more in Kansas 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· 24th of 51
$288
KS $457FL $186
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.