How much rates vary
Facilitymedian $1,288 · 10th to 90th $603 to $1,660Professionalmedian $1,445 · 10th to 90th $891 to $1,660
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,659.59 Typical High $1,659.59 | Professional | None (both parts) | $1,000.00 | $1,659.59 | $1,659.59 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,445.44 Typical High $1,905.46 | Professional | None (both parts) | $1,096.48 | $1,445.44 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | None (both parts) | $933.25 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,096.48 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,819.70 | Facility | None | $602.56 | $1,023.29 | $1,819.70 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,318.26 Typical High $2,238.72 | Professional | None (both parts) | $1,047.13 | $1,318.26 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,258.93 | $1,318.26 |
United Setting Professional Modifier None (both parts) Typical Low $724.44 Median $933.25 Typical High $1,318.26 | Professional | None (both parts) | $724.44 | $933.25 | $1,318.26 |
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 $512.86 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $512.86 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $204.17 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $102.33 | $165.96 | $165.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $524.81 Median $562.34 Typical High $1,258.93 | Professional | 26 · Professional part | $524.81 | $562.34 | $1,258.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,995.26 Typical High $6,309.57 | Professional | 50 · Both sides | $1,584.89 | $1,995.26 | $6,309.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $660.69 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $524.81 | $660.69 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $263.03 Typical High $851.14 | Professional | 80 · Assistant surgeon | $213.80 | $263.03 | $851.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $186.21 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $147.91 | $186.21 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $186.21 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $186.21 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $186.21 Typical High $588.84 | Professional | AS · PA/NP assist | $147.91 | $186.21 | $588.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | SH · Second concurrent infusion | $524.81 | $524.81 | $524.81 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | SJ · Third+ concurrent infusion | $524.81 | $524.81 | $524.81 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $794.33 Median $851.14 Typical High $1,905.46 | Professional | TC · Technical part | $794.33 | $851.14 | $1,905.46 |
Where North Carolina sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 17th of 51
$1,445
HI $3,020AL $933
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.