How much rates vary
Facilitymedian $1,549 · 10th to 90th $759 to $2,512Professionalmedian $2,188 · 10th to 90th $1,318 to $2,512
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 $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,348.96 Median $2,511.89 Typical High $2,511.89 | Professional | None (both parts) | $1,348.96 | $2,511.89 | $2,511.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,818.38 | Facility | None | $2,344.23 | $2,344.23 | $2,818.38 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,187.76 Typical High $2,884.03 | Professional | None (both parts) | $1,659.59 | $2,187.76 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | None (both parts) | $1,122.02 | $1,548.82 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,258.93 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,511.89 | Facility | None | $758.58 | $1,548.82 | $2,511.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $1,995.26 Typical High $3,388.44 | Professional | None (both parts) | $1,584.89 | $1,995.26 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,584.89 | $1,659.59 |
United Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,348.96 Typical High $1,778.28 | Professional | None (both parts) | $954.99 | $1,348.96 | $1,778.28 |
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 $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $676.08 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $269.15 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $204.17 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $134.90 | $251.19 | $251.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $794.33 Median $851.14 Typical High $1,905.46 | Professional | 26 · Professional part | $794.33 | $851.14 | $1,905.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,019.95 Typical High $9,549.93 | Professional | 50 · Both sides | $2,398.83 | $3,019.95 | $9,549.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $1,000.00 Typical High $3,235.94 | Professional | 51 · Multiple procedures | $794.33 | $1,000.00 | $3,235.94 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $1,288.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $281.84 Typical High $891.25 | Professional | 81 · Minimal assistant surgeon | $223.87 | $281.84 | $891.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $281.84 Typical High $891.25 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $281.84 | $891.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $281.84 Typical High $891.25 | Professional | AS · PA/NP assist | $223.87 | $281.84 | $891.25 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | SH · Second concurrent infusion | $794.33 | $794.33 | $794.33 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | SJ · Third+ concurrent infusion | $794.33 | $794.33 | $794.33 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,202.26 Median $1,288.25 Typical High $2,884.03 | Professional | TC · Technical part | $1,202.26 | $1,288.25 | $2,884.03 |
Where North Carolina sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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
$2,188
HI $3,467DE $1,122
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.