How much rates vary
Facilitymedian $45 · 10th to 90th $20 to $46Professionalmedian $47 · 10th to 90th $30 to $51
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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | None (both parts) | $35.48 | $45.71 | $45.71 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $35.48 Median $46.77 Typical High $63.10 | Professional | None (both parts) | $35.48 | $46.77 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $33.11 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $33.11 | $44.67 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $52.48 | Professional | None | $30.20 | $32.36 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $19.95 Median $33.11 Typical High $50.12 | Facility | None | $19.95 | $33.11 | $50.12 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $43.65 Typical High $74.13 | Professional | None (both parts) | $33.88 | $43.65 | $74.13 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $37.15 | Facility | None | $36.31 | $36.31 | $37.15 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $30.90 Typical High $45.71 | Professional | None (both parts) | $23.44 | $30.90 | $45.71 |
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 $17.38 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $17.38 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $7.08 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $5.25 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.55 | $4.57 | $4.57 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $18.62 Typical High $40.74 | Professional | 26 · Professional part | $17.78 | $18.62 | $40.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $66.07 Typical High $208.93 | Professional | 50 · Both sides | $51.29 | $66.07 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $21.88 Typical High $69.18 | Professional | 51 · Multiple procedures | $16.98 | $21.88 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $8.71 Typical High $27.54 | Professional | 80 · Assistant surgeon | $6.76 | $8.71 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $6.17 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $4.79 | $6.17 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $6.17 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $6.17 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $6.17 Typical High $19.50 | Professional | AS · PA/NP assist | $4.79 | $6.17 | $19.50 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | SH · Second concurrent infusion | $16.98 | $16.98 | $16.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | SJ · Third+ concurrent infusion | $16.98 | $16.98 | $16.98 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.30 Median $27.54 Typical High $61.66 | Professional | TC · Technical part | $26.30 | $27.54 | $61.66 |
Where North Carolina sits
The same service costs 2.5 times more in Hawaii 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· 19th of 51
$45.71
HI $81.28FL $33.11
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.