How much rates vary
Facilitymedian $158 · 10th to 90th $72 to $174Professionalmedian $178 · 10th to 90th $112 to $195
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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | None (both parts) | $120.23 | $173.78 | $173.78 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $177.83 Typical High $234.42 | Professional | None (both parts) | $134.90 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna 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 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | None | $138.04 | $147.91 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $190.55 | Facility | None | $72.44 | $125.89 | $190.55 |
Medcost Setting Professional Modifier None (both parts) Typical Low $128.82 Median $162.18 Typical High $275.42 | Professional | None (both parts) | $128.82 | $162.18 | $275.42 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $89.13 Median $114.82 Typical High $169.82 | Professional | None (both parts) | $89.13 | $114.82 | $169.82 |
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 $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $60.26 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $23.99 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $18.20 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.02 | $17.38 | $17.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $64.57 Median $69.18 Typical High $154.88 | Professional | 26 · Professional part | $64.57 | $69.18 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $245.47 Typical High $776.25 | Professional | 50 · Both sides | $194.98 | $245.47 | $776.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $81.28 Typical High $263.03 | Professional | 51 · Multiple procedures | $64.57 | $81.28 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.70 Median $32.36 Typical High $104.71 | Professional | 80 · Assistant surgeon | $25.70 | $32.36 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.20 Median $22.91 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $18.20 | $22.91 | $72.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.20 Median $22.91 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $18.20 | $22.91 | $72.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.20 Median $22.91 Typical High $72.44 | Professional | AS · PA/NP assist | $18.20 | $22.91 | $72.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | SH · Second concurrent infusion | $64.57 | $64.57 | $64.57 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | SJ · Third+ concurrent infusion | $64.57 | $64.57 | $64.57 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $97.72 Median $104.71 Typical High $234.42 | Professional | TC · Technical part | $97.72 | $104.71 | $234.42 |
Where North Carolina sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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· 18th of 51
$174
HI $282NJ $117
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.