How much rates vary
Facilitymedian $25 · 10th to 90th $9 to $26Professionalmedian $25 · 10th to 90th $16 to $26
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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $23.44 Typical High $23.44 | Professional | None (both parts) | $15.49 | $23.44 | $23.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $31.62 | Facility | None | $26.30 | $26.30 | $31.62 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $24.55 Typical High $25.70 | Professional | None (both parts) | $23.44 | $24.55 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $21.38 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $21.38 | $25.12 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $20.42 | Professional | None | $14.79 | $15.85 | $20.42 |
Medcost Setting Facility Modifier None Typical Low $9.12 Median $23.44 Typical High $28.18 | Facility | None | $9.12 | $23.44 | $28.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $22.39 Median $22.39 Typical High $38.02 | Professional | None (both parts) | $22.39 | $22.39 | $38.02 |
United Setting Professional Modifier None (both parts) Typical Low $12.02 Median $15.85 Typical High $21.88 | Professional | None (both parts) | $12.02 | $15.85 | $21.88 |
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 $7.76 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $7.76 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $3.09 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.29 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.55 | $2.34 | $2.34 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $8.91 Median $9.55 Typical High $21.38 | Professional | 26 · Professional part | $8.91 | $9.55 | $21.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $33.11 Median $33.11 Typical High $107.15 | Professional | 50 · Both sides | $33.11 | $33.11 | $107.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.22 Median $11.22 Typical High $36.31 | Professional | 51 · Multiple procedures | $11.22 | $11.22 | $36.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.47 Median $4.47 Typical High $14.45 | Professional | 80 · Assistant surgeon | $4.47 | $4.47 | $14.45 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.09 Median $3.09 Typical High $10.00 | Professional | 81 · Minimal assistant surgeon | $3.09 | $3.09 | $10.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.09 Median $3.09 Typical High $10.00 | Professional | 82 · Assistant surgeon, no resident | $3.09 | $3.09 | $10.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.09 Median $3.09 Typical High $10.00 | Professional | AS · PA/NP assist | $3.09 | $3.09 | $10.00 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | SH · Second concurrent infusion | $11.22 | $11.22 | $11.22 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | SJ · Third+ concurrent infusion | $11.22 | $11.22 | $11.22 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $13.49 Median $14.45 Typical High $32.36 | Professional | TC · Technical part | $13.49 | $14.45 | $32.36 |
Where North Carolina sits
The same service costs 2.1 times more in Minnesota 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· 23rd of 51
$24.55
MN $37.15DC $17.38
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.