How much rates vary
Facilitymedian $100 · 10th to 90th $51 to $117Professionalmedian $123 · 10th to 90th $74 to $135
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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $79.43 | $117.49 | $117.49 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $93.33 Median $123.03 Typical High $162.18 | Professional | None (both parts) | $93.33 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $72.44 | $100.00 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $109.65 | Professional | None | $100.00 | $107.15 | $109.65 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $87.10 Typical High $131.83 | Facility | None | $51.29 | $87.10 | $131.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $89.13 Median $112.20 Typical High $190.55 | Professional | None (both parts) | $89.13 | $112.20 | $190.55 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Facility | None | $102.33 | $102.33 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $61.66 Median $79.43 Typical High $120.23 | Professional | None (both parts) | $61.66 | $79.43 | $120.23 |
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 $40.74 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $11.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $47.86 Typical High $107.15 | Professional | 26 · Professional part | $44.67 | $47.86 | $107.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $169.82 Typical High $537.03 | Professional | 50 · Both sides | $134.90 | $169.82 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $56.23 Typical High $181.97 | Professional | 51 · Multiple procedures | $44.67 | $56.23 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $22.39 Typical High $72.44 | Professional | 80 · Assistant surgeon | $18.20 | $22.39 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.59 Median $15.85 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $12.59 | $15.85 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.59 Median $15.85 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $12.59 | $15.85 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.59 Median $15.85 Typical High $50.12 | Professional | AS · PA/NP assist | $12.59 | $15.85 | $50.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | SH · Second concurrent infusion | $44.67 | $44.67 | $44.67 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | SJ · Third+ concurrent infusion | $44.67 | $44.67 | $44.67 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $67.61 Median $72.44 Typical High $162.18 | Professional | TC · Technical part | $67.61 | $72.44 | $162.18 |
Where North Carolina sits
The same service costs 4.1 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· 19th of 51
$120
HI $295DE $72.44
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.