How much rates vary
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 $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,818.38 Typical High $2,818.38 | Professional | None (both parts) | $1,819.70 | $2,818.38 | $2,818.38 |
BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,801.89 | Facility | None | $3,162.28 | $3,162.28 | $3,801.89 |
BCBS Setting Professional Modifier None (both parts) Typical Low $2,238.72 Median $2,951.21 Typical High $3,890.45 | Professional | None (both parts) | $2,238.72 | $2,951.21 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | None (both parts) | $1,778.28 | $2,454.71 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,905.46 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $3,162.28 | Facility | None | $1,096.48 | $2,089.30 | $3,162.28 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,691.53 Typical High $4,570.88 | Professional | None (both parts) | $2,137.96 | $2,691.53 | $4,570.88 |
United Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $1,905.46 Typical High $2,630.27 | Professional | None (both parts) | $1,445.44 | $1,905.46 | $2,630.27 |
12 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 55 · Aftercare only Typical Low $281.84 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $281.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $186.21 | $281.84 | $281.84 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,071.52 Median $1,148.15 Typical High $2,570.40 | Professional | 26 · Professional part | $1,071.52 | $1,148.15 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,235.94 Median $4,073.80 Typical High $12,882.50 | Professional | 50 · Both sides | $3,235.94 | $4,073.80 | $12,882.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,348.96 Typical High $4,365.16 | Professional | 51 · Multiple procedures | $1,071.52 | $1,348.96 | $4,365.16 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $537.03 Typical High $1,737.80 | Professional | 80 · Assistant surgeon | $426.58 | $537.03 | $1,737.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $380.19 Typical High $1,202.26 | Professional | 81 · Minimal assistant surgeon | $302.00 | $380.19 | $1,202.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $380.19 Typical High $1,202.26 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $380.19 | $1,202.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $380.19 Typical High $1,202.26 | Professional | AS · PA/NP assist | $302.00 | $380.19 | $1,202.26 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | SH · Second concurrent infusion | $1,071.52 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | SJ · Third+ concurrent infusion | $1,071.52 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,621.81 Median $1,737.80 Typical High $3,890.45 | Professional | TC · Technical part | $1,621.81 | $1,737.80 | $3,890.45 |
Where North Carolina sits
The same service costs 2.3 times more in Montana 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· 17th of 51
$2,884
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.