How much rates vary
Facilitymedian $562 · 10th to 90th $240 to $661Professionalmedian $575 · 10th to 90th $372 to $661
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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | None (both parts) | $398.11 | $562.34 | $562.34 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $562.34 Median $575.44 Typical High $660.69 | Professional | None (both parts) | $562.34 | $575.44 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None (both parts) Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | None (both parts) | $562.34 | $660.69 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $501.19 | Professional | None | $346.74 | $371.54 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $616.60 | Facility | None | $239.88 | $407.38 | $616.60 |
Medcost Setting Professional Modifier None (both parts) Typical Low $416.87 Median $524.81 Typical High $891.25 | Professional | None (both parts) | $416.87 | $524.81 | $891.25 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None (both parts) Typical Low $288.40 Median $371.54 Typical High $562.34 | Professional | None (both parts) | $288.40 | $371.54 | $562.34 |
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 $199.53 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $39.81 | $56.23 | $56.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $223.87 Typical High $501.19 | Professional | 26 · Professional part | $208.93 | $223.87 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $794.33 Typical High $2,511.89 | Professional | 50 · Both sides | $630.96 | $794.33 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $263.03 Typical High $851.14 | Professional | 51 · Multiple procedures | $208.93 | $263.03 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $104.71 Typical High $338.84 | Professional | 80 · Assistant surgeon | $83.18 | $104.71 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $74.13 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $58.88 | $74.13 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $74.13 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $74.13 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $74.13 Typical High $234.42 | Professional | AS · PA/NP assist | $58.88 | $74.13 | $234.42 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | SH · Second concurrent infusion | $208.93 | $208.93 | $208.93 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | SJ · Third+ concurrent infusion | $208.93 | $208.93 | $208.93 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $316.23 Median $338.84 Typical High $758.58 | Professional | TC · Technical part | $316.23 | $338.84 | $758.58 |
Where North Carolina sits
The same service costs 2.5 times more in Montana 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· 21st of 51
$575
MT $1,047DC $417
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.