How much rates vary
Facilitymedian $1,622 · 10th to 90th $776 to $2,138Professionalmedian $1,862 · 10th to 90th $1,175 to $2,138
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $1,288.25 | $2,137.96 | $2,137.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,398.83 | Facility | None | $2,041.74 | $2,041.74 | $2,398.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,862.09 Typical High $2,511.89 | Professional | None (both parts) | $1,412.54 | $1,862.09 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | None (both parts) | $1,202.26 | $1,621.81 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,318.26 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $1,348.96 Typical High $2,344.23 | Facility | None | $776.25 | $1,348.96 | $2,344.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,698.24 Typical High $2,951.21 | Professional | None (both parts) | $1,380.38 | $1,698.24 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,479.11 | $1,479.11 | $1,513.56 |
United Setting Professional Modifier None (both parts) Typical Low $933.25 Median $1,202.26 Typical High $1,737.80 | Professional | None (both parts) | $933.25 | $1,202.26 | $1,737.80 |
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 $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $645.65 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $263.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $194.98 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $128.82 | $213.80 | $213.80 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $691.83 Median $741.31 Typical High $1,659.59 | Professional | 26 · Professional part | $691.83 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,570.40 Typical High $8,317.64 | Professional | 50 · Both sides | $2,041.74 | $2,570.40 | $8,317.64 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $851.14 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $691.83 | $851.14 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $346.74 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $275.42 | $346.74 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $239.88 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $190.55 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $239.88 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $239.88 | $776.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $776.25 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $776.25 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | SH · Second concurrent infusion | $691.83 | $691.83 | $691.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | SJ · Third+ concurrent infusion | $691.83 | $691.83 | $691.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,023.29 Median $1,096.48 Typical High $2,454.71 | Professional | TC · Technical part | $1,023.29 | $1,096.48 | $2,454.71 |
Where North Carolina sits
The same service costs 2.7 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· 18th of 51
$1,862
HI $3,236DE $1,202
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.