How much rates vary
Facilitymedian $245 · 10th to 90th $107 to $295Professionalmedian $309 · 10th to 90th $182 to $339
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $177.83 | $295.12 | $295.12 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $234.42 Median $309.03 Typical High $407.38 | Professional | None (both parts) | $234.42 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | None (both parts) | $177.83 | $245.47 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | None | $199.53 | $218.78 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $218.78 Typical High $331.13 | Facility | None | $107.15 | $218.78 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $223.87 Median $281.84 Typical High $478.63 | Professional | None (both parts) | $223.87 | $281.84 | $478.63 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Facility | None | $169.82 | $169.82 | $173.78 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $199.53 Typical High $257.04 | Professional | None (both parts) | $151.36 | $199.53 | $257.04 |
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 $89.13 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $89.13 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.78 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $120.23 Typical High $269.15 | Professional | 26 · Professional part | $112.20 | $120.23 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $426.58 Typical High $1,348.96 | Professional | 50 · Both sides | $338.84 | $426.58 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | 51 · Multiple procedures | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $56.23 Typical High $181.97 | Professional | 80 · Assistant surgeon | $44.67 | $56.23 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $39.81 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $31.62 | $39.81 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $39.81 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $39.81 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $39.81 Typical High $125.89 | Professional | AS · PA/NP assist | $31.62 | $39.81 | $125.89 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SH · Second concurrent infusion | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SJ · Third+ concurrent infusion | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $169.82 Median $181.97 Typical High $407.38 | Professional | TC · Technical part | $169.82 | $181.97 | $407.38 |
Where North Carolina sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 15th of 51
$302
WI $407CO $178
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.