How much rates vary
Facilitymedian $525 · 10th to 90th $200 to $550Professionalmedian $479 · 10th to 90th $295 to $550
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $323.59 Median $549.54 Typical High $549.54 | Professional | None (both parts) | $323.59 | $549.54 | $549.54 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None (both parts) | $478.63 | $478.63 | $478.63 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $363.08 Median $478.63 Typical High $630.96 | Professional | None (both parts) | $363.08 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $380.19 Median $524.81 Typical High $524.81 | Professional | None (both parts) | $380.19 | $524.81 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $446.68 | Professional | None | $288.40 | $316.23 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $602.56 | Facility | None | $199.53 | $338.84 | $602.56 |
Medcost Setting Professional Modifier None (both parts) Typical Low $354.81 Median $436.52 Typical High $758.58 | Professional | None (both parts) | $354.81 | $436.52 | $758.58 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None (both parts) Typical Low $239.88 Median $309.03 Typical High $436.52 | Professional | None (both parts) | $239.88 | $309.03 | $436.52 |
15 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 $165.96 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $66.07 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $48.98 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.11 | $54.95 | $54.95 |
Cigna Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $173.78 Median $186.21 Typical High $416.87 | Professional | 26 · Professional part | $173.78 | $186.21 | $416.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $660.69 Typical High $2,137.96 | Professional | 50 · Both sides | $524.81 | $660.69 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $218.78 Typical High $707.95 | Professional | 51 · Multiple procedures | $173.78 | $218.78 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $87.10 Typical High $281.84 | Professional | 80 · Assistant surgeon | $70.79 | $87.10 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $48.98 Median $61.66 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $48.98 | $61.66 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $48.98 Median $61.66 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $48.98 | $61.66 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $61.66 Typical High $199.53 | Professional | AS · PA/NP assist | $48.98 | $61.66 | $199.53 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SH · Second concurrent infusion | $173.78 | $173.78 | $173.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SJ · Third+ concurrent infusion | $173.78 | $173.78 | $173.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $263.03 Median $281.84 Typical High $630.96 | Professional | TC · Technical part | $263.03 | $281.84 | $630.96 |
Where North Carolina sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 21st of 51
$479
HI $977MD $355
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.