How much rates vary
Facilitymedian $708 · 10th to 90th $331 to $977Professionalmedian $851 · 10th to 90th $513 to $977
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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $537.03 | $977.24 | $977.24 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | None (both parts) | $676.08 | $1,023.29 | $1,023.29 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | None (both parts) | $741.31 | $851.14 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $707.95 Typical High $776.25 | Professional | None (both parts) | $512.86 | $707.95 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $870.96 | Professional | None | $478.63 | $512.86 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $616.60 Typical High $1,047.13 | Facility | None | $331.13 | $616.60 | $1,047.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $630.96 Median $794.33 Typical High $1,348.96 | Professional | None (both parts) | $630.96 | $794.33 | $1,348.96 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $691.83 | Facility | None | $478.63 | $478.63 | $691.83 |
United Setting Professional Modifier None (both parts) Typical Low $398.11 Median $549.54 Typical High $741.31 | Professional | None (both parts) | $398.11 | $549.54 | $741.31 |
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 $295.12 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $295.12 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $120.23 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $89.13 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $60.26 | $97.72 | $97.72 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $338.84 Typical High $758.58 | Professional | 26 · Professional part | $316.23 | $338.84 | $758.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,174.90 Typical High $3,801.89 | Professional | 50 · Both sides | $954.99 | $1,174.90 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $398.11 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $316.23 | $398.11 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $158.49 Typical High $501.19 | Professional | 80 · Assistant surgeon | $125.89 | $158.49 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $109.65 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $89.13 | $109.65 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $109.65 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $109.65 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $109.65 Typical High $354.81 | Professional | AS · PA/NP assist | $89.13 | $109.65 | $354.81 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | SH · Second concurrent infusion | $316.23 | $316.23 | $316.23 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | SJ · Third+ concurrent infusion | $316.23 | $316.23 | $316.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $501.19 Typical High $1,122.02 | Professional | TC · Technical part | $467.74 | $501.19 | $1,122.02 |
Where North Carolina sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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· 15th of 51
$851
HI $1,738MS $513
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.