How much rates vary
Facilitymedian $1,698 · 10th to 90th $741 to $2,291Professionalmedian $1,995 · 10th to 90th $1,202 to $2,291
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $2,290.87 Typical High $2,290.87 | Professional | None (both parts) | $1,230.27 | $2,290.87 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,995.26 Typical High $2,630.27 | Professional | None (both parts) | $1,513.56 | $1,995.26 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,698.24 Typical High $1,698.24 | Professional | None (both parts) | $1,230.27 | $1,698.24 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,148.15 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $2,344.23 | Facility | None | $741.31 | $1,412.54 | $2,344.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,819.70 Typical High $3,162.28 | Professional | None (both parts) | $1,479.11 | $1,819.70 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
United Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,258.93 Typical High $1,698.24 | Professional | None (both parts) | $870.96 | $1,258.93 | $1,698.24 |
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 $645.65 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $645.65 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $257.04 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $194.98 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $128.82 | $229.09 | $229.09 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $724.44 Median $776.25 Typical High $1,737.80 | Professional | 26 · Professional part | $724.44 | $776.25 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,754.23 Typical High $8,912.51 | Professional | 50 · Both sides | $2,187.76 | $2,754.23 | $8,912.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $912.01 Typical High $2,951.21 | Professional | 51 · Multiple procedures | $741.31 | $912.01 | $2,951.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $363.08 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $295.12 | $363.08 | $1,174.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $257.04 Typical High $831.76 | Professional | 81 · Minimal assistant surgeon | $204.17 | $257.04 | $831.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $257.04 Typical High $831.76 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $257.04 | $831.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $257.04 Typical High $831.76 | Professional | AS · PA/NP assist | $204.17 | $257.04 | $831.76 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | SH · Second concurrent infusion | $741.31 | $741.31 | $741.31 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | SJ · Third+ concurrent infusion | $741.31 | $741.31 | $741.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,096.48 Median $1,174.90 Typical High $2,630.27 | Professional | TC · Technical part | $1,096.48 | $1,174.90 | $2,630.27 |
Where North Carolina sits
The same service costs 2.8 times more in Hawaii than in Arizona. 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· 13th of 51
$1,995
HI $3,388AZ $1,230
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.