How much rates vary
Facilitymedian $14 · 10th to 90th $6 to $17Professionalmedian $17 · 10th to 90th $11 to $19
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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.23 Median $16.98 Typical High $16.98 | Professional | None (both parts) | $10.23 | $16.98 | $16.98 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None (both parts) | $17.38 | $17.38 | $17.38 |
BCBS Setting Professional Modifier None (both parts) Typical Low $13.18 Median $17.38 Typical High $23.44 | Professional | None (both parts) | $13.18 | $17.38 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None (both parts) Typical Low $10.47 Median $14.45 Typical High $14.45 | Professional | None (both parts) | $10.47 | $14.45 | $14.45 |
Medcost Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $13.80 | Professional | None | $8.71 | $9.55 | $13.80 |
Medcost Setting Facility Modifier None Typical Low $6.03 Median $12.30 Typical High $18.62 | Facility | None | $6.03 | $12.30 | $18.62 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.88 Median $15.85 Typical High $27.54 | Professional | None (both parts) | $12.88 | $15.85 | $27.54 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.88 | Facility | None | $12.59 | $12.59 | $12.88 |
United Setting Professional Modifier None (both parts) Typical Low $8.71 Median $11.22 Typical High $14.45 | Professional | None (both parts) | $8.71 | $11.22 | $14.45 |
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 $5.13 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $5.13 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $2.04 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $1.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.02 | $1.70 | $1.70 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $6.46 Median $6.92 Typical High $15.14 | Professional | 26 · Professional part | $6.46 | $6.92 | $15.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $19.50 Median $23.99 Typical High $77.62 | Professional | 50 · Both sides | $19.50 | $23.99 | $77.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.46 Median $7.94 Typical High $25.70 | Professional | 51 · Multiple procedures | $6.46 | $7.94 | $25.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.57 Median $3.24 Typical High $10.23 | Professional | 80 · Assistant surgeon | $2.57 | $3.24 | $10.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.82 Median $2.24 Typical High $7.24 | Professional | 81 · Minimal assistant surgeon | $1.82 | $2.24 | $7.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.82 Median $2.24 Typical High $7.24 | Professional | 82 · Assistant surgeon, no resident | $1.82 | $2.24 | $7.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.82 Median $2.24 Typical High $7.24 | Professional | AS · PA/NP assist | $1.82 | $2.24 | $7.24 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | SH · Second concurrent infusion | $6.46 | $6.46 | $6.46 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | SJ · Third+ concurrent infusion | $6.46 | $6.46 | $6.46 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $9.55 Median $10.23 Typical High $22.91 | Professional | TC · Technical part | $9.55 | $10.23 | $22.91 |
Where North Carolina sits
The same service costs 3.0 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· 16th of 51
$16.98
HI $31.62DE $10.47
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.