How much rates vary
Facilitymedian $363 · 10th to 90th $162 to $417Professionalmedian $427 · 10th to 90th $269 to $427
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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | None (both parts) | $269.15 | $416.87 | $416.87 |
BCBS Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $562.34 | Facility | None | $467.74 | $467.74 | $562.34 |
BCBS Setting Professional Modifier None (both parts) Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | None (both parts) | $371.54 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None (both parts) Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | None (both parts) | $263.03 | $363.08 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $363.08 | Professional | None | $263.03 | $281.84 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $309.03 Typical High $457.09 | Facility | None | $162.18 | $309.03 | $457.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $316.23 Median $398.11 Typical High $676.08 | Professional | None (both parts) | $316.23 | $398.11 | $676.08 |
United Setting Professional Modifier None (both parts) Typical Low $213.80 Median $281.84 Typical High $380.19 | Professional | None (both parts) | $213.80 | $281.84 | $380.19 |
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 $138.04 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $138.04 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $54.95 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $40.74 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $27.54 | $41.69 | $41.69 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $158.49 Median $169.82 Typical High $380.19 | Professional | 26 · Professional part | $158.49 | $169.82 | $380.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $588.84 Typical High $1,905.46 | Professional | 50 · Both sides | $467.74 | $588.84 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $199.53 Typical High $630.96 | Professional | 51 · Multiple procedures | $158.49 | $199.53 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $79.43 Typical High $257.04 | Professional | 80 · Assistant surgeon | $63.10 | $79.43 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $43.65 Median $54.95 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $43.65 | $54.95 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $43.65 Median $54.95 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $43.65 | $54.95 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $54.95 Typical High $177.83 | Professional | AS · PA/NP assist | $43.65 | $54.95 | $177.83 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | SH · Second concurrent infusion | $158.49 | $158.49 | $158.49 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | SJ · Third+ concurrent infusion | $158.49 | $158.49 | $158.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $234.42 Median $251.19 Typical High $562.34 | Professional | TC · Technical part | $234.42 | $251.19 | $562.34 |
Where North Carolina sits
The same service costs 2.2 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
$427
MT $575DE $263
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.