How much rates vary
Facilitymedian $269 · 10th to 90th $110 to $302Professionalmedian $275 · 10th to 90th $178 to $302
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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $181.97 | $269.15 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Facility | None | $295.12 | $295.12 | $354.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | None (both parts) | $269.15 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $257.04 | $302.00 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $263.03 | Professional | None | $162.18 | $173.78 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $194.98 Typical High $295.12 | Facility | None | $109.65 | $194.98 | $295.12 |
Medcost Setting Professional Modifier None (both parts) Typical Low $204.17 Median $251.19 Typical High $436.52 | Professional | None (both parts) | $204.17 | $251.19 | $436.52 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None (both parts) Typical Low $138.04 Median $177.83 Typical High $257.04 | Professional | None (both parts) | $138.04 | $177.83 | $257.04 |
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 $91.20 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $36.31 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $27.54 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.20 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $102.33 Median $107.15 Typical High $239.88 | Professional | 26 · Professional part | $102.33 | $107.15 | $239.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $380.19 Typical High $1,230.27 | Professional | 50 · Both sides | $302.00 | $380.19 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $125.89 Typical High $407.38 | Professional | 51 · Multiple procedures | $100.00 | $125.89 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $50.12 Typical High $162.18 | Professional | 80 · Assistant surgeon | $40.74 | $50.12 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $35.48 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $28.18 | $35.48 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $35.48 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $35.48 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $35.48 Typical High $114.82 | Professional | AS · PA/NP assist | $28.18 | $35.48 | $114.82 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | SH · Second concurrent infusion | $100.00 | $100.00 | $100.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | SJ · Third+ concurrent infusion | $100.00 | $100.00 | $100.00 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $151.36 Median $162.18 Typical High $363.08 | Professional | TC · Technical part | $151.36 | $162.18 | $363.08 |
Where North Carolina sits
The same service costs 3.0 times more in Iowa 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· 18th of 51
$275
IA $457NY $151
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.