How much rates vary
Facilitymedian $44 · 10th to 90th $22 to $58Professionalmedian $59 · 10th to 90th $38 to $63
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $57.54 Typical High $57.54 | Professional | None (both parts) | $37.15 | $57.54 | $57.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $56.23 Median $58.88 Typical High $63.10 | Professional | None (both parts) | $56.23 | $58.88 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | None (both parts) | $37.15 | $43.65 | $43.65 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $50.12 | Professional | None | $35.48 | $38.02 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $57.54 Typical High $69.18 | Facility | None | $21.88 | $57.54 | $69.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | None (both parts) | $53.70 | $53.70 | $91.20 |
United Setting Professional Modifier None (both parts) Typical Low $28.84 Median $38.02 Typical High $52.48 | Professional | None (both parts) | $28.84 | $38.02 | $52.48 |
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 $5.62 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $5.62 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.72 | $5.75 | $5.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $22.91 Typical High $51.29 | Professional | 26 · Professional part | $21.38 | $22.91 | $51.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $81.28 Typical High $257.04 | Professional | 50 · Both sides | $81.28 | $81.28 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $26.92 Typical High $87.10 | Professional | 51 · Multiple procedures | $26.92 | $26.92 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $10.72 Typical High $34.67 | Professional | 80 · Assistant surgeon | $10.72 | $10.72 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $7.59 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $7.59 | $7.59 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $7.59 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $7.59 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $7.59 Typical High $23.99 | Professional | AS · PA/NP assist | $7.59 | $7.59 | $23.99 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | SH · Second concurrent infusion | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | SJ · Third+ concurrent infusion | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $34.67 Typical High $77.62 | Professional | TC · Technical part | $32.36 | $34.67 | $77.62 |
Where North Carolina sits
The same service costs 2.2 times more in Montana than in West Virginia. 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· 15th of 51
$58.88
MT $81.28WV $37.15
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.