How much rates vary
Facilitymedian $295 · 10th to 90th $123 to $302Professionalmedian $302 · 10th to 90th $195 to $324
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $169.82 | $295.12 | $295.12 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $302.00 | $302.00 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $389.05 | Facility | None | $323.59 | $323.59 | $389.05 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $257.04 Median $302.00 Typical High $323.59 | Professional | None (both parts) | $257.04 | $302.00 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Facility | None | $295.12 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $213.80 Median $295.12 Typical High $302.00 | Professional | None (both parts) | $213.80 | $295.12 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $257.04 | Professional | None | $186.21 | $199.53 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $302.00 | Facility | None | $123.03 | $213.80 | $302.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $223.87 Median $275.42 Typical High $478.63 | Professional | None (both parts) | $223.87 | $275.42 | $478.63 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $199.53 Typical High $302.00 | Professional | None (both parts) | $151.36 | $199.53 | $302.00 |
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 $102.33 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $102.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $30.90 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $120.23 Typical High $263.03 | Professional | 26 · Professional part | $112.20 | $120.23 | $263.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $416.87 Typical High $1,348.96 | Professional | 50 · Both sides | $331.13 | $416.87 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $138.04 Typical High $446.68 | Professional | 51 · Multiple procedures | $112.20 | $138.04 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $56.23 Typical High $177.83 | Professional | 80 · Assistant surgeon | $44.67 | $56.23 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | AS · PA/NP assist | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SH · Second concurrent infusion | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SJ · Third+ concurrent infusion | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $165.96 Median $177.83 Typical High $398.11 | Professional | TC · Technical part | $165.96 | $177.83 | $398.11 |
Where North Carolina sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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
$302
HI $513DC $209
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.