How much rates vary
Facilitymedian $813 · 10th to 90th $288 to $1,023Professionalmedian $977 · 10th to 90th $741 to $1,288
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $1,023.29 Typical High $1,023.29 | Professional | None (both parts) | $549.54 | $1,023.29 | $1,023.29 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $870.96 | $977.24 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Facility | None | $1,380.38 | $1,380.38 | $1,659.59 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $954.99 Median $977.24 Typical High $1,288.25 | Professional | None (both parts) | $954.99 | $977.24 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
Cigna Setting Professional Modifier None (both parts) Typical Low $588.84 Median $812.83 Typical High $891.25 | Professional | None (both parts) | $588.84 | $812.83 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,230.27 | Facility | None | $288.40 | $1,023.29 | $1,230.27 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | None (both parts) | $1,288.25 | $1,288.25 | $1,659.59 |
United Setting Professional Modifier None (both parts) Typical Low $446.68 Median $776.25 Typical High $1,023.29 | Professional | None (both parts) | $446.68 | $776.25 | $1,023.29 |
16 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 $275.42 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $275.42 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $109.65 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $83.18 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $54.95 | $102.33 | $102.33 |
Cigna Setting Facility Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | RR · Rental | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | RR · Rental | $69.18 | $81.28 | $81.28 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $512.86 Median $512.86 Typical High $831.76 | Professional | 26 · Professional part | $512.86 | $512.86 | $831.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $1,949.84 Typical High $3,548.13 | Professional | 50 · Both sides | $1,949.84 | $1,949.84 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $645.65 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $645.65 | $645.65 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $257.04 Typical High $478.63 | Professional | 80 · Assistant surgeon | $257.04 | $257.04 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $181.97 | $181.97 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $181.97 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | AS · PA/NP assist | $181.97 | $181.97 | $331.13 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | SH · Second concurrent infusion | $645.65 | $645.65 | $645.65 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | SJ · Third+ concurrent infusion | $645.65 | $645.65 | $645.65 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $776.25 Typical High $1,230.27 | Professional | TC · Technical part | $776.25 | $776.25 | $1,230.27 |
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· 9th of 51
$977
HI $1,445UT $550
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.