How much rates vary
Facilitymedian $195 · 10th to 90th $76 to $224Professionalmedian $214 · 10th to 90th $138 to $234
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 $204.17 Median $204.17 Typical High $323.59 | Facility | None | $204.17 | $204.17 | $323.59 |
Aetna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $204.17 Typical High $204.17 | Professional | None (both parts) | $125.89 | $204.17 | $204.17 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $489.78 Median $489.78 Typical High $602.56 | Professional | None (both parts) | $489.78 | $489.78 | $602.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Facility | None | $229.09 | $229.09 | $275.42 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $181.97 Median $213.80 Typical High $223.87 | Professional | None (both parts) | $181.97 | $213.80 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $194.98 Typical High $194.98 | Professional | None (both parts) | $165.96 | $194.98 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $173.78 | Professional | None | $123.03 | $131.83 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $223.87 | Facility | None | $75.86 | $151.36 | $223.87 |
Medcost Setting Professional Modifier None (both parts) Typical Low $154.88 Median $194.98 Typical High $331.13 | Professional | None (both parts) | $154.88 | $194.98 | $331.13 |
United Setting Professional Modifier None (both parts) Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | None (both parts) | $104.71 | $138.04 | $181.97 |
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 $18.62 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $18.62 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.59 | $20.42 | $20.42 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $77.62 Median $83.18 Typical High $186.21 | Professional | 26 · Professional part | $77.62 | $83.18 | $186.21 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $288.40 Typical High $933.25 | Professional | 50 · Both sides | $234.42 | $288.40 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $97.72 Typical High $309.03 | Professional | 51 · Multiple procedures | $77.62 | $97.72 | $309.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $38.90 Typical High $125.89 | Professional | 80 · Assistant surgeon | $30.90 | $38.90 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $26.92 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $21.88 | $26.92 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $26.92 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $26.92 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $26.92 Typical High $87.10 | Professional | AS · PA/NP assist | $21.88 | $26.92 | $87.10 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | SH · Second concurrent infusion | $77.62 | $77.62 | $77.62 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | SJ · Third+ concurrent infusion | $77.62 | $77.62 | $77.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $125.89 Typical High $275.42 | Professional | TC · Technical part | $117.49 | $125.89 | $275.42 |
Where North Carolina sits
The same service costs 2.6 times more in Montana than in New York. 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· 14th of 51
$214
MT $275NY $107
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.