How much rates vary
Facilitymedian $166 · 10th to 90th $72 to $195Professionalmedian $174 · 10th to 90th $112 to $195
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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $165.96 Typical High $165.96 | Professional | None (both parts) | $125.89 | $165.96 | $165.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $131.83 Median $173.78 Typical High $229.09 | Professional | None (both parts) | $131.83 | $173.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | None (both parts) | $141.25 | $194.98 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $158.49 | Professional | None | $141.25 | $151.36 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $123.03 Typical High $186.21 | Facility | None | $72.44 | $123.03 | $186.21 |
Medcost Setting Professional Modifier None (both parts) Typical Low $125.89 Median $158.49 Typical High $269.15 | Professional | None (both parts) | $125.89 | $158.49 | $269.15 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
United Setting Professional Modifier None (both parts) Typical Low $87.10 Median $112.20 Typical High $169.82 | Professional | None (both parts) | $87.10 | $112.20 | $169.82 |
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 $63.10 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $25.12 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $16.60 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $63.10 Median $67.61 Typical High $151.36 | Professional | 26 · Professional part | $63.10 | $67.61 | $151.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $234.42 Typical High $758.58 | Professional | 50 · Both sides | $190.55 | $234.42 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $79.43 Typical High $257.04 | Professional | 51 · Multiple procedures | $63.10 | $79.43 | $257.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $31.62 Typical High $102.33 | Professional | 80 · Assistant surgeon | $25.12 | $31.62 | $102.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $21.88 Typical High $70.79 | Professional | 81 · Minimal assistant surgeon | $17.78 | $21.88 | $70.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $21.88 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $21.88 | $70.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $21.88 Typical High $70.79 | Professional | AS · PA/NP assist | $17.78 | $21.88 | $70.79 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | SH · Second concurrent infusion | $63.10 | $63.10 | $63.10 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | SJ · Third+ concurrent infusion | $63.10 | $63.10 | $63.10 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $102.33 Typical High $229.09 | Professional | TC · Technical part | $95.50 | $102.33 | $229.09 |
Where North Carolina sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$174
HI $407DC $129
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.