How much rates vary
Facilitymedian $49 · 10th to 90th $25 to $68Professionalmedian $69 · 10th to 90th $41 to $76
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $39.81 | $67.61 | $67.61 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $52.48 Median $69.18 Typical High $91.20 | Professional | None (both parts) | $52.48 | $69.18 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $48.98 Typical High $50.12 | Professional | None (both parts) | $35.48 | $48.98 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $57.54 | Professional | None | $36.31 | $38.90 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $48.98 Typical High $74.13 | Facility | None | $25.12 | $48.98 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $51.29 Median $64.57 Typical High $107.15 | Professional | None (both parts) | $51.29 | $64.57 | $107.15 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $39.81 | Facility | None | $19.95 | $19.95 | $39.81 |
United Setting Professional Modifier None (both parts) Typical Low $33.88 Median $44.67 Typical High $60.26 | Professional | None (both parts) | $33.88 | $44.67 | $60.26 |
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 $20.42 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $20.42 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $8.13 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $6.17 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.07 | $6.76 | $6.76 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $26.92 Typical High $60.26 | Professional | 26 · Professional part | $25.70 | $26.92 | $60.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $95.50 Typical High $302.00 | Professional | 50 · Both sides | $75.86 | $95.50 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.70 Median $32.36 Typical High $102.33 | Professional | 51 · Multiple procedures | $25.70 | $32.36 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.23 Median $12.88 Typical High $40.74 | Professional | 80 · Assistant surgeon | $10.23 | $12.88 | $40.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.08 Median $8.91 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $7.08 | $8.91 | $28.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.08 Median $8.91 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $7.08 | $8.91 | $28.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.08 Median $8.91 Typical High $28.18 | Professional | AS · PA/NP assist | $7.08 | $8.91 | $28.18 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SH · Second concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | SJ · Third+ concurrent infusion | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $40.74 Typical High $91.20 | Professional | TC · Technical part | $38.02 | $40.74 | $91.20 |
Where North Carolina sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 11th of 51
$67.61
MT $107NJ $38.90
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.