How much rates vary
Facilitymedian $141 · 10th to 90th $71 to $162Professionalmedian $166 · 10th to 90th $107 to $182
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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $107.15 | $162.18 | $162.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $213.80 | Facility | None | $177.83 | $177.83 | $213.80 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $158.49 Median $165.96 Typical High $223.87 | Professional | None (both parts) | $158.49 | $165.96 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | None (both parts) | $102.33 | $141.25 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | None | $134.90 | $144.54 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $117.49 Typical High $177.83 | Facility | None | $70.79 | $117.49 | $177.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $123.03 Median $151.36 Typical High $263.03 | Professional | None (both parts) | $123.03 | $151.36 | $263.03 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $158.49 | Facility | None | $144.54 | $144.54 | $158.49 |
United Setting Professional Modifier None (both parts) Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | None (both parts) | $83.18 | $109.65 | $162.18 |
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 $53.70 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $53.70 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $21.38 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $16.22 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.72 | $16.22 | $16.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $61.66 Median $66.07 Typical High $147.91 | Professional | 26 · Professional part | $61.66 | $66.07 | $147.91 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $229.09 Typical High $741.31 | Professional | 50 · Both sides | $181.97 | $229.09 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $75.86 Typical High $245.47 | Professional | 51 · Multiple procedures | $61.66 | $75.86 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $30.90 Typical High $97.72 | Professional | 80 · Assistant surgeon | $24.55 | $30.90 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $21.38 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $16.98 | $21.38 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $21.38 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $21.38 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $21.38 Typical High $69.18 | Professional | AS · PA/NP assist | $16.98 | $21.38 | $69.18 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | SH · Second concurrent infusion | $61.66 | $61.66 | $61.66 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | SJ · Third+ concurrent infusion | $61.66 | $61.66 | $61.66 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $97.72 Typical High $218.78 | Professional | TC · Technical part | $91.20 | $97.72 | $218.78 |
Where North Carolina sits
The same service costs 3.7 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
$166
HI $380FL $102
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.