How much rates vary
Facilitymedian $126 · 10th to 90th $62 to $145Professionalmedian $148 · 10th to 90th $93 to $162
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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | None (both parts) | $112.20 | $144.54 | $144.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $112.20 Median $147.91 Typical High $194.98 | Professional | None (both parts) | $112.20 | $147.91 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $93.33 | $125.89 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $151.36 | Professional | None | $109.65 | $117.49 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $158.49 | Facility | None | $61.66 | $104.71 | $158.49 |
Medcost Setting Professional Modifier None (both parts) Typical Low $107.15 Median $134.90 Typical High $229.09 | Professional | None (both parts) | $107.15 | $134.90 | $229.09 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Facility | None | $100.00 | $100.00 | $120.23 |
United Setting Professional Modifier None (both parts) Typical Low $74.13 Median $95.50 Typical High $144.54 | Professional | None (both parts) | $74.13 | $95.50 | $144.54 |
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 $57.54 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $22.91 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $14.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $57.54 Typical High $128.82 | Professional | 26 · Professional part | $54.95 | $57.54 | $128.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $204.17 Typical High $645.65 | Professional | 50 · Both sides | $162.18 | $204.17 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $67.61 Typical High $218.78 | Professional | 51 · Multiple procedures | $53.70 | $67.61 | $218.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $26.92 Typical High $87.10 | Professional | 80 · Assistant surgeon | $21.38 | $26.92 | $87.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $19.05 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $15.14 | $19.05 | $60.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $19.05 Typical High $60.26 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $19.05 | $60.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $19.05 Typical High $60.26 | Professional | AS · PA/NP assist | $15.14 | $19.05 | $60.26 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | SH · Second concurrent infusion | $53.70 | $53.70 | $53.70 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | SJ · Third+ concurrent infusion | $53.70 | $53.70 | $53.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $87.10 Typical High $194.98 | Professional | TC · Technical part | $81.28 | $87.10 | $194.98 |
Where North Carolina sits
The same service costs 2.9 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· 22nd of 51
$145
HI $269FL $93.33
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.