How much rates vary
Facilitymedian $112 · 10th to 90th $56 to $132Professionalmedian $135 · 10th to 90th $83 to $148
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $131.83 Typical High $131.83 | Professional | None (both parts) | $89.13 | $131.83 | $131.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $102.33 Median $134.90 Typical High $177.83 | Professional | None (both parts) | $102.33 | $134.90 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $83.18 | $112.20 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | None | $100.00 | $107.15 | $117.49 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $95.50 Typical High $144.54 | Facility | None | $56.23 | $95.50 | $144.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $100.00 Median $123.03 Typical High $208.93 | Professional | None (both parts) | $100.00 | $123.03 | $208.93 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Facility | None | $75.86 | $75.86 | $104.71 |
United Setting Professional Modifier None (both parts) Typical Low $67.61 Median $87.10 Typical High $131.83 | Professional | None (both parts) | $67.61 | $87.10 | $131.83 |
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 $46.77 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $18.62 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $13.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $50.12 Median $52.48 Typical High $117.49 | Professional | 26 · Professional part | $50.12 | $52.48 | $117.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $186.21 Typical High $588.84 | Professional | 50 · Both sides | $147.91 | $186.21 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $61.66 Typical High $199.53 | Professional | 51 · Multiple procedures | $48.98 | $61.66 | $199.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $24.55 Typical High $79.43 | Professional | 80 · Assistant surgeon | $19.95 | $24.55 | $79.43 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $17.38 Typical High $54.95 | Professional | 81 · Minimal assistant surgeon | $13.80 | $17.38 | $54.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $17.38 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $17.38 | $54.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $17.38 Typical High $54.95 | Professional | AS · PA/NP assist | $13.80 | $17.38 | $54.95 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | SH · Second concurrent infusion | $48.98 | $48.98 | $48.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | SJ · Third+ concurrent infusion | $48.98 | $48.98 | $48.98 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $74.13 Median $79.43 Typical High $177.83 | Professional | TC · Technical part | $74.13 | $79.43 | $177.83 |
Where North Carolina sits
The same service costs 2.8 times more in Hawaii 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· 21st of 51
$132
HI $234DE $83.18
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.