How much rates vary
Facilitymedian $1,175 · 10th to 90th $562 to $1,698Professionalmedian $1,514 · 10th to 90th $891 to $1,698
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,698.24 Typical High $1,698.24 | Professional | None (both parts) | $977.24 | $1,698.24 | $1,698.24 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None (both parts) | $1,513.56 | $1,513.56 | $1,513.56 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,513.56 Typical High $1,995.26 | Professional | None (both parts) | $1,148.15 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,174.90 Typical High $1,202.26 | Professional | None (both parts) | $870.96 | $1,174.90 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,174.90 | Professional | None | $954.99 | $1,023.29 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,905.46 | Facility | None | $562.34 | $1,071.52 | $1,905.46 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,380.38 Typical High $2,344.23 | Professional | None (both parts) | $1,096.48 | $1,380.38 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,174.90 | $1,479.11 |
United Setting Professional Modifier None (both parts) Typical Low $676.08 Median $977.24 Typical High $1,288.25 | Professional | None (both parts) | $676.08 | $977.24 | $1,288.25 |
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 $489.78 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $489.78 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $194.98 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $144.54 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $97.72 | $169.82 | $169.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $549.54 Median $588.84 Typical High $1,318.26 | Professional | 26 · Professional part | $549.54 | $588.84 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,041.74 Typical High $6,606.93 | Professional | 50 · Both sides | $1,659.59 | $2,041.74 | $6,606.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $691.83 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $549.54 | $691.83 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $891.25 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $891.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $190.55 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $154.88 | $190.55 | $616.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $190.55 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $190.55 | $616.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $190.55 Typical High $616.60 | Professional | AS · PA/NP assist | $154.88 | $190.55 | $616.60 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | SH · Second concurrent infusion | $549.54 | $549.54 | $549.54 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | SJ · Third+ concurrent infusion | $549.54 | $549.54 | $549.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $831.76 Median $891.25 Typical High $1,995.26 | Professional | TC · Technical part | $831.76 | $891.25 | $1,995.26 |
Where North Carolina sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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· 19th of 51
$1,514
HI $3,467PA $871
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.