How much rates vary
Facilitymedian $174 · 10th to 90th $71 to $182Professionalmedian $170 · 10th to 90th $110 to $186
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 $117.49 Median $165.96 Typical High $165.96 | Professional | None (both parts) | $117.49 | $165.96 | $165.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $162.18 Median $169.82 Typical High $229.09 | Professional | None (both parts) | $162.18 | $169.82 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | None (both parts) | $131.83 | $181.97 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | None | $138.04 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $120.23 Typical High $181.97 | Facility | None | $70.79 | $120.23 | $181.97 |
Medcost Setting Professional Modifier None (both parts) Typical Low $125.89 Median $154.88 Typical High $269.15 | Professional | None (both parts) | $125.89 | $154.88 | $269.15 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Facility | None | $147.91 | $147.91 | $173.78 |
United Setting Professional Modifier None (both parts) Typical Low $85.11 Median $109.65 Typical High $165.96 | Professional | None (both parts) | $85.11 | $109.65 | $165.96 |
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 $58.88 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $58.88 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $23.44 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.75 | $16.60 | $16.60 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $63.10 Median $66.07 Typical High $147.91 | Professional | 26 · Professional part | $63.10 | $66.07 | $147.91 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $234.42 Typical High $758.58 | Professional | 50 · Both sides | $186.21 | $234.42 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $77.62 Typical High $251.19 | Professional | 51 · Multiple procedures | $63.10 | $77.62 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $30.90 Typical High $100.00 | Professional | 80 · Assistant surgeon | $25.12 | $30.90 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $21.88 Typical High $70.79 | Professional | 81 · Minimal assistant surgeon | $17.38 | $21.88 | $70.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $21.88 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $21.88 | $70.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $21.88 Typical High $70.79 | Professional | AS · PA/NP assist | $17.38 | $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 $93.33 Median $100.00 Typical High $223.87 | Professional | TC · Technical part | $93.33 | $100.00 | $223.87 |
Where North Carolina sits
The same service costs 3.5 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· 20th of 51
$170
HI $427DC $120
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.