How much rates vary
Facilitymedian $7 · 10th to 90th $4 to $8Professionalmedian $9 · 10th to 90th $5 to $9
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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $5.37 Median $8.13 Typical High $8.13 | Professional | None (both parts) | $5.37 | $8.13 | $8.13 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $10.23 Median $10.23 Typical High $11.75 | Professional | None (both parts) | $10.23 | $10.23 | $11.75 |
BCBS Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $10.96 | Facility | None | $9.12 | $9.12 | $10.96 |
BCBS Setting Professional Modifier None (both parts) Typical Low $8.13 Median $8.51 Typical High $11.22 | Professional | None (both parts) | $8.13 | $8.51 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None (both parts) Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | None (both parts) | $5.25 | $7.08 | $7.08 |
Medcost Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $7.41 | Professional | None | $5.89 | $6.31 | $7.41 |
Medcost Setting Facility Modifier None Typical Low $3.55 Median $6.03 Typical High $9.12 | Facility | None | $3.55 | $6.03 | $9.12 |
Medcost Setting Professional Modifier None (both parts) Typical Low $6.03 Median $7.94 Typical High $13.18 | Professional | None (both parts) | $6.03 | $7.94 | $13.18 |
United Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Facility | None | $6.31 | $6.31 | $7.94 |
United Setting Professional Modifier None (both parts) Typical Low $4.27 Median $5.50 Typical High $8.32 | Professional | None (both parts) | $4.27 | $5.50 | $8.32 |
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 $2.75 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $2.75 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.10 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $0.81 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.55 | $0.81 | $0.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3.24 Median $3.31 Typical High $7.41 | Professional | 26 · Professional part | $3.24 | $3.31 | $7.41 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $8.91 Median $12.02 Typical High $37.15 | Professional | 50 · Both sides | $8.91 | $12.02 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.98 Typical High $12.59 | Professional | 51 · Multiple procedures | $3.02 | $3.98 | $12.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.20 Median $1.58 Typical High $5.01 | Professional | 80 · Assistant surgeon | $1.20 | $1.58 | $5.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.83 Median $1.12 Typical High $3.47 | Professional | 81 · Minimal assistant surgeon | $0.83 | $1.12 | $3.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.83 Median $1.12 Typical High $3.47 | Professional | 82 · Assistant surgeon, no resident | $0.83 | $1.12 | $3.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.83 Median $1.12 Typical High $3.47 | Professional | AS · PA/NP assist | $0.83 | $1.12 | $3.47 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | SH · Second concurrent infusion | $3.02 | $3.02 | $3.02 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | SJ · Third+ concurrent infusion | $3.02 | $3.02 | $3.02 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4.79 Median $5.01 Typical High $11.22 | Professional | TC · Technical part | $4.79 | $5.01 | $11.22 |
Where North Carolina sits
The same service costs 3.5 times more in Montana 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· 22nd of 51
$8.32
MT $15.49KS $4.37
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.