How much rates vary
Facilitymedian $457 · 10th to 90th $219 to $794Professionalmedian $692 · 10th to 90th $355 to $794
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 $794.33 Median $794.33 Typical High $954.99 | Facility | None | $794.33 | $794.33 | $954.99 |
Aetna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $794.33 Typical High $794.33 | Professional | None (both parts) | $407.38 | $794.33 | $794.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $912.01 | Facility | None | $758.58 | $758.58 | $912.01 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $537.03 Median $691.83 Typical High $933.25 | Professional | None (both parts) | $537.03 | $691.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None (both parts) Typical Low $338.84 Median $457.09 Typical High $478.63 | Professional | None (both parts) | $338.84 | $457.09 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $537.03 | Professional | None | $316.23 | $346.74 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $501.19 Typical High $794.33 | Facility | None | $218.78 | $501.19 | $794.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $275.42 Median $512.86 Typical High $1,096.48 | Professional | None (both parts) | $275.42 | $512.86 | $1,096.48 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None (both parts) Typical Low $302.00 Median $436.52 Typical High $537.03 | Professional | None (both parts) | $302.00 | $436.52 | $537.03 |
16 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 $218.78 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $218.78 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $87.10 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $64.57 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $43.65 | $79.43 | $79.43 |
Cigna Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | RR · Rental | $45.71 | $45.71 | $45.71 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $109.65 Median $275.42 Typical High $616.60 | Professional | 26 · Professional part | $109.65 | $275.42 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $776.25 Typical High $3,090.30 | Professional | 50 · Both sides | $416.87 | $776.25 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $257.04 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $138.04 | $257.04 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $102.33 Typical High $416.87 | Professional | 80 · Assistant surgeon | $54.95 | $102.33 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.90 Median $72.44 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $38.90 | $72.44 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.90 Median $72.44 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $38.90 | $72.44 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $72.44 Typical High $288.40 | Professional | AS · PA/NP assist | $38.90 | $72.44 | $288.40 |
Medcost Setting Professional Modifier RR · Rental Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | RR · Rental | $51.29 | $51.29 | $51.29 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | SH · Second concurrent infusion | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | SJ · Third+ concurrent infusion | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $165.96 Median $407.38 Typical High $912.01 | Professional | TC · Technical part | $165.96 | $407.38 | $912.01 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 7th of 51
$692
HI $871NH $339
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.