How much rates vary
Facilitymedian $759 · 10th to 90th $251 to $832Professionalmedian $776 · 10th to 90th $589 to $977
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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None (both parts) Typical Low $457.09 Median $831.76 Typical High $831.76 | Professional | None (both parts) | $457.09 | $831.76 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Facility | None | $1,047.13 | $1,047.13 | $1,258.93 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $758.58 Median $776.25 Typical High $977.24 | Professional | None (both parts) | $758.58 | $776.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | None (both parts) | $549.54 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $831.76 Typical High $977.24 | Facility | None | $251.19 | $831.76 | $977.24 |
Medcost Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None (both parts) | $977.24 | $977.24 | $1,288.25 |
United Setting Professional Modifier None (both parts) Typical Low $389.05 Median $588.84 Typical High $870.96 | Professional | None (both parts) | $389.05 | $588.84 | $870.96 |
15 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 $234.42 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $234.42 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $93.33 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $70.79 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $46.77 | $83.18 | $83.18 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | CG · Policy criteria applied | $870.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $389.05 Median $389.05 Typical High $616.60 | Professional | 26 · Professional part | $389.05 | $389.05 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,445.44 Typical High $3,019.95 | Professional | 50 · Both sides | $1,445.44 | $1,445.44 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $489.78 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $489.78 | $489.78 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | 80 · Assistant surgeon | $194.98 | $194.98 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $134.90 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $134.90 | $134.90 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $134.90 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $134.90 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $134.90 Typical High $281.84 | Professional | AS · PA/NP assist | $134.90 | $134.90 | $281.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | SH · Second concurrent infusion | $489.78 | $489.78 | $489.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | SJ · Third+ concurrent infusion | $489.78 | $489.78 | $489.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $588.84 Median $588.84 Typical High $933.25 | Professional | TC · Technical part | $588.84 | $588.84 | $933.25 |
Where North Carolina sits
The same service costs 2.6 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
$776
HI $1,230UT $479
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.