How much rates vary
Facilitymedian $166 · 10th to 90th $85 to $219Professionalmedian $224 · 10th to 90th $135 to $245
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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $141.25 Median $218.78 Typical High $218.78 | Professional | None (both parts) | $141.25 | $218.78 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Facility | None | $245.47 | $245.47 | $288.40 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $169.82 Median $223.87 Typical High $302.00 | Professional | None (both parts) | $169.82 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $165.96 Typical High $173.78 | Professional | None (both parts) | $120.23 | $165.96 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $177.83 | Professional | None | $123.03 | $134.90 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $162.18 Typical High $239.88 | Facility | None | $85.11 | $162.18 | $239.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $165.96 Median $208.93 Typical High $354.81 | Professional | None (both parts) | $165.96 | $208.93 | $354.81 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $112.20 Median $147.91 Typical High $204.17 | Professional | None (both parts) | $112.20 | $147.91 | $204.17 |
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 $70.79 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $28.18 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $21.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $89.13 Typical High $199.53 | Professional | 26 · Professional part | $83.18 | $89.13 | $199.53 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $309.03 Typical High $1,000.00 | Professional | 50 · Both sides | $245.47 | $309.03 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $102.33 Typical High $331.13 | Professional | 51 · Multiple procedures | $83.18 | $102.33 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $41.69 Typical High $131.83 | Professional | 80 · Assistant surgeon | $33.11 | $41.69 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.91 Median $28.84 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $22.91 | $28.84 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.91 Median $28.84 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $22.91 | $28.84 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $28.84 Typical High $93.33 | Professional | AS · PA/NP assist | $22.91 | $28.84 | $93.33 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | SH · Second concurrent infusion | $83.18 | $83.18 | $83.18 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | SJ · Third+ concurrent infusion | $83.18 | $83.18 | $83.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $131.83 Typical High $295.12 | Professional | TC · Technical part | $123.03 | $131.83 | $295.12 |
Where North Carolina sits
The same service costs 2.8 times more in Montana 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· 17th of 51
$219
MT $331DE $120
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.