How much rates vary
Facilitymedian $562 · 10th to 90th $282 to $933Professionalmedian $813 · 10th to 90th $490 to $933
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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $489.78 Median $933.25 Typical High $933.25 | Professional | None (both parts) | $489.78 | $933.25 | $933.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Facility | None | $891.25 | $891.25 | $1,071.52 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $707.95 Median $812.83 Typical High $870.96 | Professional | None (both parts) | $707.95 | $812.83 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None (both parts) Typical Low $416.87 Median $562.34 Typical High $562.34 | Professional | None (both parts) | $416.87 | $562.34 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $588.84 | Professional | None | $407.38 | $436.52 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $588.84 Typical High $933.25 | Facility | None | $281.84 | $588.84 | $933.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $602.56 Median $758.58 Typical High $1,288.25 | Professional | None (both parts) | $602.56 | $758.58 | $1,288.25 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
United Setting Professional Modifier None (both parts) Typical Low $354.81 Median $512.86 Typical High $660.69 | Professional | None (both parts) | $354.81 | $512.86 | $660.69 |
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 $257.04 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $257.04 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $102.33 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $75.86 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $51.29 | $93.33 | $93.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $323.59 Typical High $724.44 | Professional | 26 · Professional part | $295.12 | $323.59 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,122.02 Typical High $3,630.78 | Professional | 50 · Both sides | $912.01 | $1,122.02 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $380.19 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $302.00 | $380.19 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $151.36 Typical High $489.78 | Professional | 80 · Assistant surgeon | $120.23 | $151.36 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $104.71 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $85.11 | $104.71 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $104.71 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $104.71 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $104.71 Typical High $338.84 | Professional | AS · PA/NP assist | $85.11 | $104.71 | $338.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | SH · Second concurrent infusion | $302.00 | $302.00 | $302.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | SJ · Third+ concurrent infusion | $302.00 | $302.00 | $302.00 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $436.52 Median $489.78 Typical High $1,071.52 | Professional | TC · Technical part | $436.52 | $489.78 | $1,071.52 |
Where North Carolina sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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· 11th of 51
$813
HI $1,230KS $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.