How much rates vary
Facilitymedian $832 · 10th to 90th $407 to $1,259Professionalmedian $1,096 · 10th to 90th $661 to $1,259
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | None (both parts) | $676.08 | $1,258.93 | $1,258.93 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,096.48 Typical High $1,096.48 | Professional | None (both parts) | $954.99 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $831.76 Typical High $870.96 | Professional | None (both parts) | $616.60 | $831.76 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $831.76 | Professional | None | $616.60 | $660.69 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $776.25 Typical High $1,348.96 | Facility | None | $407.38 | $776.25 | $1,348.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $794.33 Median $1,000.00 Typical High $1,513.56 | Professional | None (both parts) | $794.33 | $1,000.00 | $1,513.56 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None (both parts) Typical Low $478.63 Median $707.95 Typical High $933.25 | Professional | None (both parts) | $478.63 | $707.95 | $933.25 |
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 $354.81 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $354.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $141.25 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $107.15 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $70.79 | $125.89 | $125.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $398.11 Median $436.52 Typical High $977.24 | Professional | 26 · Professional part | $398.11 | $436.52 | $977.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $4,897.79 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $4,897.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $501.19 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $398.11 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $645.65 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | AS · PA/NP assist | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | SH · Second concurrent infusion | $398.11 | $398.11 | $398.11 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | SJ · Third+ concurrent infusion | $398.11 | $398.11 | $398.11 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $602.56 Median $645.65 Typical High $1,445.44 | Professional | TC · Technical part | $602.56 | $645.65 | $1,445.44 |
Where North Carolina sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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
$1,096
HI $1,950DE $617
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.