How much rates vary
Facilitymedian $282 · 10th to 90th $138 to $331Professionalmedian $347 · 10th to 90th $209 to $380
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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $213.80 Median $331.13 Typical High $331.13 | Professional | None (both parts) | $213.80 | $331.13 | $331.13 |
BCBS Setting Professional Modifier None (both parts) Typical Low $263.03 Median $346.74 Typical High $457.09 | Professional | None (both parts) | $263.03 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $204.17 | $281.84 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | None | $239.88 | $257.04 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $371.54 | Facility | None | $138.04 | $245.47 | $371.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $316.23 Typical High $537.03 | Professional | None (both parts) | $251.19 | $316.23 | $537.03 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Facility | None | $288.40 | $288.40 | $389.05 |
United Setting Professional Modifier None (both parts) Typical Low $173.78 Median $223.87 Typical High $323.59 | Professional | None (both parts) | $173.78 | $223.87 | $323.59 |
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 $107.15 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $107.15 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $42.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $32.36 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.38 | $33.11 | $33.11 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $134.90 Typical High $302.00 | Professional | 26 · Professional part | $125.89 | $134.90 | $302.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $467.74 Typical High $1,513.56 | Professional | 50 · Both sides | $380.19 | $467.74 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $158.49 Typical High $501.19 | Professional | 51 · Multiple procedures | $125.89 | $158.49 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $63.10 Typical High $204.17 | Professional | 80 · Assistant surgeon | $50.12 | $63.10 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $43.65 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $35.48 | $43.65 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $43.65 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $43.65 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $43.65 Typical High $141.25 | Professional | AS · PA/NP assist | $35.48 | $43.65 | $141.25 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SH · Second concurrent infusion | $125.89 | $125.89 | $125.89 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SJ · Third+ concurrent infusion | $125.89 | $125.89 | $125.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $190.55 Median $204.17 Typical High $457.09 | Professional | TC · Technical part | $190.55 | $204.17 | $457.09 |
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· 17th of 51
$339
HI $832DE $204
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.