How much rates vary
Facilitymedian $324 · 10th to 90th $141 to $363Professionalmedian $331 · 10th to 90th $214 to $363
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 $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None (both parts) Typical Low $245.47 Median $323.59 Typical High $323.59 | Professional | None (both parts) | $245.47 | $323.59 | $323.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $436.52 | Facility | None | $363.08 | $363.08 | $436.52 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $251.19 Median $331.13 Typical High $446.68 | Professional | None (both parts) | $251.19 | $331.13 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $363.08 Typical High $363.08 | Professional | None (both parts) | $269.15 | $363.08 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $309.03 | Professional | None | $204.17 | $218.78 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $354.81 | Facility | None | $141.25 | $239.88 | $354.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $245.47 Median $309.03 Typical High $524.81 | Professional | None (both parts) | $245.47 | $309.03 | $524.81 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
United Setting Professional Modifier None (both parts) Typical Low $165.96 Median $218.78 Typical High $331.13 | Professional | None (both parts) | $165.96 | $218.78 | $331.13 |
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 $123.03 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $32.36 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $123.03 Median $131.83 Typical High $295.12 | Professional | 26 · Professional part | $123.03 | $131.83 | $295.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $457.09 Typical High $1,479.11 | Professional | 50 · Both sides | $371.54 | $457.09 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $154.88 Typical High $489.78 | Professional | 51 · Multiple procedures | $123.03 | $154.88 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $61.66 Typical High $194.98 | Professional | 80 · Assistant surgeon | $48.98 | $61.66 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $42.66 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $34.67 | $42.66 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $42.66 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $42.66 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $42.66 Typical High $138.04 | Professional | AS · PA/NP assist | $34.67 | $42.66 | $138.04 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | SH · Second concurrent infusion | $123.03 | $123.03 | $123.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | SJ · Third+ concurrent infusion | $123.03 | $123.03 | $123.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $186.21 Median $194.98 Typical High $436.52 | Professional | TC · Technical part | $186.21 | $194.98 | $436.52 |
Where North Carolina sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. 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· 21st of 51
$331
WI $550PA $245
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.