How much rates vary
Facilitymedian $178 · 10th to 90th $89 to $209Professionalmedian $214 · 10th to 90th $129 to $234
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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | None (both parts) | $138.04 | $208.93 | $208.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Facility | None | $229.09 | $229.09 | $275.42 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $162.18 Median $213.80 Typical High $281.84 | Professional | None (both parts) | $162.18 | $213.80 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | None (both parts) | $128.82 | $177.83 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | None | $173.78 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $151.36 Typical High $229.09 | Facility | None | $89.13 | $151.36 | $229.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $158.49 Median $194.98 Typical High $331.13 | Professional | None (both parts) | $158.49 | $194.98 | $331.13 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
United Setting Professional Modifier None (both parts) Typical Low $107.15 Median $138.04 Typical High $208.93 | Professional | None (both parts) | $107.15 | $138.04 | $208.93 |
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 $74.13 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $74.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $21.88 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $20.89 | $20.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $77.62 Median $83.18 Typical High $186.21 | Professional | 26 · Professional part | $77.62 | $83.18 | $186.21 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $295.12 Typical High $933.25 | Professional | 50 · Both sides | $234.42 | $295.12 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $97.72 Typical High $316.23 | Professional | 51 · Multiple procedures | $77.62 | $97.72 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $38.90 Typical High $125.89 | Professional | 80 · Assistant surgeon | $31.62 | $38.90 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $27.54 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $21.88 | $27.54 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $27.54 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $27.54 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $27.54 Typical High $87.10 | Professional | AS · PA/NP assist | $21.88 | $27.54 | $87.10 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | SH · Second concurrent infusion | $77.62 | $77.62 | $77.62 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | SJ · Third+ concurrent infusion | $77.62 | $77.62 | $77.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $125.89 Typical High $281.84 | Professional | TC · Technical part | $117.49 | $125.89 | $281.84 |
Where North Carolina sits
The same service costs 3.5 times more in Hawaii 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· 24th of 51
$209
HI $447DE $129
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.