How much rates vary
Facilitymedian $1,047 · 10th to 90th $407 to $1,122Professionalmedian $977 · 10th to 90th $631 to $1,122
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None (both parts) Typical Low $630.96 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $630.96 | $1,122.02 | $1,122.02 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $831.76 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | None (both parts) | $776.25 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $851.14 | Professional | None | $676.08 | $724.44 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $691.83 Typical High $1,230.27 | Facility | None | $407.38 | $691.83 | $1,230.27 |
Medcost Setting Professional Modifier None (both parts) Typical Low $724.44 Median $891.25 Typical High $1,548.82 | Professional | None (both parts) | $724.44 | $891.25 | $1,548.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $977.24 | Facility | None | $851.14 | $851.14 | $977.24 |
United Setting Professional Modifier None (both parts) Typical Low $489.78 Median $630.96 Typical High $851.14 | Professional | None (both parts) | $489.78 | $630.96 | $851.14 |
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 $316.23 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $316.23 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $125.89 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $95.50 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $63.10 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $354.81 Median $380.19 Typical High $851.14 | Professional | 26 · Professional part | $354.81 | $380.19 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,348.96 Typical High $4,365.16 | Professional | 50 · Both sides | $1,071.52 | $1,348.96 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $446.68 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $363.08 | $446.68 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $177.83 Typical High $575.44 | Professional | 80 · Assistant surgeon | $144.54 | $177.83 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $125.89 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $100.00 | $125.89 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $125.89 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $125.89 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $125.89 Typical High $407.38 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $407.38 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | SH · Second concurrent infusion | $363.08 | $363.08 | $363.08 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | SJ · Third+ concurrent infusion | $363.08 | $363.08 | $363.08 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $537.03 Median $575.44 Typical High $1,288.25 | Professional | TC · Technical part | $537.03 | $575.44 | $1,288.25 |
Where North Carolina sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 20th of 51
$977
HI $2,399FL $676
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.