How much rates vary
Facilitymedian $380 · 10th to 90th $120 to $407Professionalmedian $363 · 10th to 90th $275 to $457
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $218.78 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $218.78 | $398.11 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Facility | None | $489.78 | $489.78 | $588.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $354.81 Median $363.08 Typical High $457.09 | Professional | None (both parts) | $354.81 | $363.08 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $281.84 Median $380.19 Typical High $380.19 | Professional | None (both parts) | $281.84 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $398.11 Typical High $457.09 | Facility | None | $120.23 | $398.11 | $457.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None (both parts) | $457.09 | $457.09 | $630.96 |
United Setting Professional Modifier None (both parts) Typical Low $181.97 Median $275.42 Typical High $407.38 | Professional | None (both parts) | $181.97 | $275.42 | $407.38 |
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 $112.20 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $44.67 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $33.11 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.39 | $39.81 | $39.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | 26 · Professional part | $181.97 | $181.97 | $288.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $676.08 Typical High $1,445.44 | Professional | 50 · Both sides | $676.08 | $676.08 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $229.09 Typical High $478.63 | Professional | 51 · Multiple procedures | $229.09 | $229.09 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $91.20 Typical High $190.55 | Professional | 80 · Assistant surgeon | $91.20 | $91.20 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $63.10 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $63.10 | $63.10 | $134.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $63.10 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $63.10 | $134.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $63.10 Typical High $134.90 | Professional | AS · PA/NP assist | $63.10 | $63.10 | $134.90 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | SH · Second concurrent infusion | $229.09 | $229.09 | $229.09 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | SJ · Third+ concurrent infusion | $229.09 | $229.09 | $229.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $275.42 Typical High $436.52 | Professional | TC · Technical part | $275.42 | $275.42 | $436.52 |
Where North Carolina sits
The same service costs 3.0 times more in Hawaii than in Utah. 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· 10th of 51
$363
HI $661UT $224
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.