How much rates vary
Facilitymedian $355 · 10th to 90th $155 to $363Professionalmedian $372 · 10th to 90th $240 to $407
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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $275.42 | $354.81 | $354.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $281.84 Median $371.54 Typical High $489.78 | Professional | None (both parts) | $281.84 | $371.54 | $489.78 |
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 $269.15 Median $363.08 Typical High $363.08 | Professional | None (both parts) | $269.15 | $363.08 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $363.08 | Professional | None | $251.19 | $269.15 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $263.03 Typical High $398.11 | Facility | None | $154.88 | $263.03 | $398.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $269.15 Median $338.84 Typical High $575.44 | Professional | None (both parts) | $269.15 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $323.59 | Facility | None | $239.88 | $239.88 | $323.59 |
United Setting Professional Modifier None (both parts) Typical Low $186.21 Median $239.88 Typical High $363.08 | Professional | None (both parts) | $186.21 | $239.88 | $363.08 |
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 $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $35.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $134.90 Median $144.54 Typical High $323.59 | Professional | 26 · Professional part | $134.90 | $144.54 | $323.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $512.86 Typical High $1,621.81 | Professional | 50 · Both sides | $407.38 | $512.86 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $169.82 Typical High $549.54 | Professional | 51 · Multiple procedures | $134.90 | $169.82 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $67.61 Typical High $218.78 | Professional | 80 · Assistant surgeon | $53.70 | $67.61 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.02 Median $47.86 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $38.02 | $47.86 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.02 Median $47.86 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $38.02 | $47.86 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $47.86 Typical High $151.36 | Professional | AS · PA/NP assist | $38.02 | $47.86 | $151.36 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | SH · Second concurrent infusion | $134.90 | $134.90 | $134.90 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | SJ · Third+ concurrent infusion | $134.90 | $134.90 | $134.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $204.17 Median $218.78 Typical High $489.78 | Professional | TC · Technical part | $204.17 | $218.78 | $489.78 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 21st of 51
$363
HI $708AL $269
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.