How much rates vary
Facilitymedian $295 · 10th to 90th $135 to $355Professionalmedian $363 · 10th to 90th $219 to $398
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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $223.87 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $223.87 | $354.81 | $354.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $275.42 Median $363.08 Typical High $478.63 | Professional | None (both parts) | $275.42 | $363.08 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $213.80 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $213.80 | $295.12 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $309.03 | Professional | None | $218.78 | $234.42 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $257.04 Typical High $389.05 | Facility | None | $134.90 | $257.04 | $389.05 |
Medcost Setting Professional Modifier None (both parts) Typical Low $263.03 Median $331.13 Typical High $562.34 | Professional | None (both parts) | $263.03 | $331.13 | $562.34 |
United Setting Professional Modifier None (both parts) Typical Low $181.97 Median $234.42 Typical High $323.59 | Professional | None (both parts) | $181.97 | $234.42 | $323.59 |
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 $34.67 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.91 | $35.48 | $35.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $141.25 Typical High $316.23 | Professional | 26 · Professional part | $131.83 | $141.25 | $316.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $501.19 Typical High $1,584.89 | Professional | 50 · Both sides | $398.11 | $501.19 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $165.96 Typical High $537.03 | Professional | 51 · Multiple procedures | $131.83 | $165.96 | $537.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $66.07 Typical High $213.80 | Professional | 80 · Assistant surgeon | $52.48 | $66.07 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $46.77 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $37.15 | $46.77 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $46.77 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $46.77 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $46.77 Typical High $147.91 | Professional | AS · PA/NP assist | $37.15 | $46.77 | $147.91 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | SH · Second concurrent infusion | $131.83 | $131.83 | $131.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | SJ · Third+ concurrent infusion | $131.83 | $131.83 | $131.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $213.80 Typical High $478.63 | Professional | TC · Technical part | $199.53 | $213.80 | $478.63 |
Where North Carolina sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$355
HI $490KS $162
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.