How much rates vary
Facilitymedian $380 · 10th to 90th $191 to $437Professionalmedian $447 · 10th to 90th $275 to $447
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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None (both parts) Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $288.40 | $436.52 | $436.52 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $446.68 Median $537.03 Typical High $630.96 | Professional | None (both parts) | $446.68 | $537.03 | $630.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $389.05 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $389.05 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | None (both parts) | $275.42 | $380.19 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $389.05 | Professional | None | $316.23 | $346.74 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $478.63 | Facility | None | $190.55 | $316.23 | $478.63 |
Medcost Setting Professional Modifier None (both parts) Typical Low $331.13 Median $407.38 Typical High $707.95 | Professional | None (both parts) | $331.13 | $407.38 | $707.95 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $389.05 | Facility | None | $346.74 | $346.74 | $389.05 |
United Setting Professional Modifier None (both parts) Typical Low $223.87 Median $295.12 Typical High $436.52 | Professional | None (both parts) | $223.87 | $295.12 | $436.52 |
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 $144.54 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $57.54 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $42.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.84 | $43.65 | $43.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $165.96 Median $177.83 Typical High $398.11 | Professional | 26 · Professional part | $165.96 | $177.83 | $398.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $616.60 Typical High $1,995.26 | Professional | 50 · Both sides | $489.78 | $616.60 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $204.17 Typical High $660.69 | Professional | 51 · Multiple procedures | $165.96 | $204.17 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $83.18 Typical High $263.03 | Professional | 80 · Assistant surgeon | $66.07 | $83.18 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $57.54 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $45.71 | $57.54 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $57.54 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $57.54 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $57.54 Typical High $186.21 | Professional | AS · PA/NP assist | $45.71 | $57.54 | $186.21 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | SH · Second concurrent infusion | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | SJ · Third+ concurrent infusion | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $245.47 Median $263.03 Typical High $588.84 | Professional | TC · Technical part | $245.47 | $263.03 | $588.84 |
Where North Carolina sits
The same service costs 3.2 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· 20th of 51
$447
HI $871DE $275
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.