How much rates vary
Facilitymedian $158 · 10th to 90th $68 to $166Professionalmedian $162 · 10th to 90th $105 to $178
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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | None (both parts) | $117.49 | $158.49 | $158.49 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $123.03 Median $162.18 Typical High $213.80 | Professional | None (both parts) | $123.03 | $162.18 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $165.96 Typical High $165.96 | Professional | None (both parts) | $120.23 | $165.96 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $158.49 | Professional | None | $123.03 | $131.83 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $114.82 Typical High $173.78 | Facility | None | $67.61 | $114.82 | $173.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $120.23 Median $147.91 Typical High $251.19 | Professional | None (both parts) | $120.23 | $147.91 | $251.19 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $104.71 Typical High $158.49 | Professional | None (both parts) | $81.28 | $104.71 | $158.49 |
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 $60.26 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $24.55 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.30 | $15.85 | $15.85 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $63.10 Typical High $141.25 | Professional | 26 · Professional part | $60.26 | $63.10 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $223.87 Typical High $707.95 | Professional | 50 · Both sides | $177.83 | $223.87 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $74.13 Typical High $239.88 | Professional | 51 · Multiple procedures | $58.88 | $74.13 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $29.51 Typical High $95.50 | Professional | 80 · Assistant surgeon | $23.99 | $29.51 | $95.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.60 Median $20.89 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $16.60 | $20.89 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.60 Median $20.89 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $16.60 | $20.89 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $20.89 Typical High $66.07 | Professional | AS · PA/NP assist | $16.60 | $20.89 | $66.07 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | SH · Second concurrent infusion | $58.88 | $58.88 | $58.88 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | SJ · Third+ concurrent infusion | $58.88 | $58.88 | $58.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $95.50 Typical High $213.80 | Professional | TC · Technical part | $89.13 | $95.50 | $213.80 |
Where North Carolina sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$162
HI $331FL $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.