How much rates vary
Facilitymedian $1,380 · 10th to 90th $575 to $1,622Professionalmedian $1,413 · 10th to 90th $912 to $1,622
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,621.81 Typical High $1,621.81 | Professional | None (both parts) | $977.24 | $1,621.81 | $1,621.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,548.82 | $1,862.09 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,412.54 Typical High $1,905.46 | Professional | None (both parts) | $1,380.38 | $1,412.54 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | None (both parts) | $1,023.29 | $1,380.38 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,348.96 | Professional | None | $831.76 | $891.25 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $1,778.28 | Facility | None | $575.44 | $1,023.29 | $1,778.28 |
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 $1,000.00 Median $1,000.00 Typical High $1,174.90 | Facility | None | $1,000.00 | $1,000.00 | $1,174.90 |
United Setting Professional Modifier None (both parts) Typical Low $691.83 Median $912.01 Typical High $1,230.27 | Professional | None (both parts) | $691.83 | $912.01 | $1,230.27 |
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 $501.19 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $501.19 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $199.53 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $151.36 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $100.00 | $162.18 | $162.18 |
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 $1,949.84 Typical High $6,309.57 | Professional | 50 · Both sides | $1,584.89 | $1,949.84 | $6,309.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $645.65 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $524.81 | $645.65 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $831.76 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $181.97 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $147.91 | $181.97 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $181.97 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $181.97 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $588.84 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $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 $776.25 Median $831.76 Typical High $1,862.09 | Professional | TC · Technical part | $776.25 | $831.76 | $1,862.09 |
Where North Carolina sits
The same service costs 2.7 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· 19th of 51
$1,413
HI $2,630FL $977
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.