How much rates vary
Facilitymedian $631 · 10th to 90th $427 to $759Professionalmedian $692 · 10th to 90th $525 to $871
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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None (both parts) Typical Low $426.58 Median $758.58 Typical High $758.58 | Professional | None (both parts) | $426.58 | $758.58 | $758.58 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $676.08 Median $691.83 Typical High $870.96 | Professional | None (both parts) | $676.08 | $691.83 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $630.96 Typical High $707.95 | Professional | None (both parts) | $467.74 | $630.96 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $758.58 Typical High $870.96 | Facility | None | $426.58 | $758.58 | $870.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $870.96 Median $870.96 Typical High $1,202.26 | Professional | None (both parts) | $870.96 | $870.96 | $1,202.26 |
United Setting Professional Modifier None (both parts) Typical Low $346.74 Median $524.81 Typical High $776.25 | Professional | None (both parts) | $346.74 | $524.81 | $776.25 |
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 $213.80 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $213.80 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $85.11 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $64.57 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $42.66 | $75.86 | $75.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | 26 · Professional part | $346.74 | $346.74 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,288.25 Typical High $2,754.23 | Professional | 50 · Both sides | $1,288.25 | $1,288.25 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $436.52 Typical High $912.01 | Professional | 51 · Multiple procedures | $436.52 | $436.52 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $173.78 Typical High $371.54 | Professional | 80 · Assistant surgeon | $173.78 | $173.78 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $120.23 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $120.23 | $120.23 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $120.23 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $120.23 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $120.23 Typical High $257.04 | Professional | AS · PA/NP assist | $120.23 | $120.23 | $257.04 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | SH · Second concurrent infusion | $436.52 | $436.52 | $436.52 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | SJ · Third+ concurrent infusion | $436.52 | $436.52 | $436.52 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $524.81 Median $524.81 Typical High $831.76 | Professional | TC · Technical part | $524.81 | $524.81 | $831.76 |
Where North Carolina sits
The same service costs 2.2 times more in Kansas than in Utah. 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· 12th of 51
$692
KS $1,000UT $457
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.