How much rates vary
Facilitymedian $741 · 10th to 90th $339 to $912Professionalmedian $794 · 10th to 90th $490 to $912
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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $912.01 Typical High $912.01 | Professional | None (both parts) | $549.54 | $912.01 | $912.01 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $794.33 Typical High $1,071.52 | Professional | None (both parts) | $602.56 | $794.33 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | None (both parts) | $537.03 | $741.31 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $741.31 | Professional | None | $524.81 | $562.34 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $1,000.00 | Facility | None | $338.84 | $562.34 | $1,000.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $588.84 Median $724.44 Typical High $1,258.93 | Professional | None (both parts) | $588.84 | $724.44 | $1,258.93 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Facility | None | $691.83 | $691.83 | $933.25 |
United Setting Professional Modifier None (both parts) Typical Low $398.11 Median $524.81 Typical High $741.31 | Professional | None (both parts) | $398.11 | $524.81 | $741.31 |
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 $275.42 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $275.42 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $109.65 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $54.95 | $91.20 | $91.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $316.23 Typical High $707.95 | Professional | 26 · Professional part | $295.12 | $316.23 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $3,548.13 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $363.08 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $295.12 | $363.08 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $467.74 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $81.28 Median $102.33 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $81.28 | $102.33 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $81.28 Median $102.33 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $81.28 | $102.33 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $331.13 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $331.13 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | SH · Second concurrent infusion | $295.12 | $295.12 | $295.12 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | SJ · Third+ concurrent infusion | $295.12 | $295.12 | $295.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $436.52 Median $467.74 Typical High $1,047.13 | Professional | TC · Technical part | $436.52 | $467.74 | $1,047.13 |
Where North Carolina sits
The same service costs 4.2 times more in Hawaii than in Florida. 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· 18th of 51
$794
HI $2,239FL $537
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.