How much rates vary
Facilitymedian $162 · 10th to 90th $83 to $191Professionalmedian $200 · 10th to 90th $129 to $219
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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | None (both parts) | $134.90 | $190.55 | $190.55 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $190.55 Median $199.53 Typical High $263.03 | Professional | None (both parts) | $190.55 | $199.53 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $117.49 | $162.18 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | None | $162.18 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $141.25 Typical High $213.80 | Facility | None | $83.18 | $141.25 | $213.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $144.54 Median $181.97 Typical High $309.03 | Professional | None (both parts) | $144.54 | $181.97 | $309.03 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $128.82 | Facility | None | $104.71 | $104.71 | $128.82 |
United Setting Professional Modifier None (both parts) Typical Low $100.00 Median $128.82 Typical High $194.98 | Professional | None (both parts) | $100.00 | $128.82 | $194.98 |
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 $69.18 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $69.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $72.44 Median $77.62 Typical High $173.78 | Professional | 26 · Professional part | $72.44 | $77.62 | $173.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $275.42 Typical High $870.96 | Professional | 50 · Both sides | $218.78 | $275.42 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $91.20 Typical High $295.12 | Professional | 51 · Multiple procedures | $72.44 | $91.20 | $295.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $36.31 Typical High $117.49 | Professional | 80 · Assistant surgeon | $28.84 | $36.31 | $117.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $25.70 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $20.42 | $25.70 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $25.70 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $25.70 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $25.70 Typical High $81.28 | Professional | AS · PA/NP assist | $20.42 | $25.70 | $81.28 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | SH · Second concurrent infusion | $72.44 | $72.44 | $72.44 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | SJ · Third+ concurrent infusion | $72.44 | $72.44 | $72.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $109.65 Median $117.49 Typical High $263.03 | Professional | TC · Technical part | $109.65 | $117.49 | $263.03 |
Where North Carolina sits
The same service costs 2.8 times more in Minnesota 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· 20th of 51
$195
MN $331DE $117
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.