How much rates vary
Facilitymedian $245 · 10th to 90th $112 to $269Professionalmedian $269 · 10th to 90th $174 to $295
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $181.97 | $263.03 | $263.03 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $204.17 Median $269.15 Typical High $354.81 | Professional | None (both parts) | $204.17 | $269.15 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | None (both parts) | $177.83 | $245.47 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $234.42 | Professional | None | $190.55 | $204.17 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $288.40 | Facility | None | $112.20 | $190.55 | $288.40 |
Medcost Setting Professional Modifier None (both parts) Typical Low $194.98 Median $245.47 Typical High $416.87 | Professional | None (both parts) | $194.98 | $245.47 | $416.87 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
United Setting Professional Modifier None (both parts) Typical Low $134.90 Median $173.78 Typical High $263.03 | Professional | None (both parts) | $134.90 | $173.78 | $263.03 |
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 $93.33 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $37.15 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $26.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $97.72 Median $104.71 Typical High $234.42 | Professional | 26 · Professional part | $97.72 | $104.71 | $234.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $371.54 Typical High $1,174.90 | Professional | 50 · Both sides | $295.12 | $371.54 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $123.03 Typical High $398.11 | Professional | 51 · Multiple procedures | $97.72 | $123.03 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $48.98 Typical High $158.49 | Professional | 80 · Assistant surgeon | $39.81 | $48.98 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $34.67 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $27.54 | $34.67 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $34.67 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $34.67 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $34.67 Typical High $109.65 | Professional | AS · PA/NP assist | $27.54 | $34.67 | $109.65 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | SH · Second concurrent infusion | $97.72 | $97.72 | $97.72 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | SJ · Third+ concurrent infusion | $97.72 | $97.72 | $97.72 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $147.91 Median $158.49 Typical High $354.81 | Professional | TC · Technical part | $147.91 | $158.49 | $354.81 |
Where North Carolina sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 20th of 51
$263
HI $646TN $178
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.