How much rates vary
Facilitymedian $229 · 10th to 90th $117 to $295Professionalmedian $302 · 10th to 90th $182 to $331
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $186.21 | $295.12 | $295.12 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $229.09 Median $302.00 Typical High $407.38 | Professional | None (both parts) | $229.09 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $229.09 Typical High $234.42 | Professional | None (both parts) | $165.96 | $229.09 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $275.42 | Professional | None | $181.97 | $194.98 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $323.59 | Facility | None | $117.49 | $218.78 | $323.59 |
Medcost Setting Professional Modifier None (both parts) Typical Low $223.87 Median $281.84 Typical High $478.63 | Professional | None (both parts) | $223.87 | $281.84 | $478.63 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $199.53 Typical High $281.84 | Professional | None (both parts) | $151.36 | $199.53 | $281.84 |
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 $100.00 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $100.00 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $30.20 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $120.23 Typical High $269.15 | Professional | 26 · Professional part | $112.20 | $120.23 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $416.87 Typical High $1,348.96 | Professional | 50 · Both sides | $338.84 | $416.87 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $141.25 Typical High $446.68 | Professional | 51 · Multiple procedures | $112.20 | $141.25 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $56.23 Typical High $177.83 | Professional | 80 · Assistant surgeon | $44.67 | $56.23 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $38.90 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $31.62 | $38.90 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $38.90 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $38.90 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.90 Typical High $125.89 | Professional | AS · PA/NP assist | $31.62 | $38.90 | $125.89 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SH · Second concurrent infusion | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SJ · Third+ concurrent infusion | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $169.82 Median $177.83 Typical High $398.11 | Professional | TC · Technical part | $169.82 | $177.83 | $398.11 |
Where North Carolina sits
The same service costs 2.7 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· 16th of 51
$302
MT $457DE $170
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.