How much rates vary
Facilitymedian $1,148 · 10th to 90th $479 to $1,479Professionalmedian $1,288 · 10th to 90th $794 to $1,479
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $831.76 | $1,479.11 | $1,479.11 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,288.25 Typical High $1,737.80 | Professional | None (both parts) | $977.24 | $1,288.25 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | None (both parts) | $831.76 | $1,148.15 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,000.00 | Professional | None | $851.14 | $933.25 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $933.25 Typical High $1,621.81 | Facility | None | $478.63 | $933.25 | $1,621.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,174.90 Typical High $2,041.74 | Professional | None (both parts) | $954.99 | $1,174.90 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Facility | None | $1,000.00 | $1,000.00 | $1,258.93 |
United Setting Professional Modifier None (both parts) Typical Low $575.44 Median $812.83 Typical High $1,122.02 | Professional | None (both parts) | $575.44 | $812.83 | $1,122.02 |
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 $416.87 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $416.87 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $165.96 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $125.89 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $83.18 | $147.91 | $147.91 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $478.63 Median $512.86 Typical High $1,148.15 | Professional | 26 · Professional part | $478.63 | $512.86 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,778.28 Typical High $5,754.40 | Professional | 50 · Both sides | $1,412.54 | $1,778.28 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $588.84 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $478.63 | $588.84 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $239.88 Typical High $758.58 | Professional | 80 · Assistant surgeon | $190.55 | $239.88 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $165.96 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $131.83 | $165.96 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $165.96 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $165.96 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $165.96 Typical High $537.03 | Professional | AS · PA/NP assist | $131.83 | $165.96 | $537.03 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | SH · Second concurrent infusion | $478.63 | $478.63 | $478.63 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | SJ · Third+ concurrent infusion | $478.63 | $478.63 | $478.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $707.95 Median $758.58 Typical High $1,698.24 | Professional | TC · Technical part | $707.95 | $758.58 | $1,698.24 |
Where North Carolina sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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
$1,288
HI $3,236WV $832
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.