How much rates vary
Facilitymedian $832 · 10th to 90th $427 to $1,148Professionalmedian $1,000 · 10th to 90th $603 to $1,148
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | None (both parts) | $676.08 | $1,148.15 | $1,148.15 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,000.00 Typical High $1,348.96 | Professional | None (both parts) | $758.58 | $1,000.00 | $1,348.96 |
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 $602.56 Median $831.76 Typical High $831.76 | Professional | None (both parts) | $602.56 | $831.76 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $933.25 | Professional | None | $616.60 | $660.69 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $724.44 Typical High $1,258.93 | Facility | None | $426.58 | $724.44 | $1,258.93 |
Medcost Setting Professional Modifier None (both parts) Typical Low $741.31 Median $933.25 Typical High $1,584.89 | Professional | None (both parts) | $741.31 | $933.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Facility | None | $870.96 | $870.96 | $1,348.96 |
United Setting Professional Modifier None (both parts) Typical Low $501.19 Median $660.69 Typical High $891.25 | Professional | None (both parts) | $501.19 | $660.69 | $891.25 |
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 $346.74 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $346.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $138.04 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $102.33 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $69.18 | $114.82 | $114.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $371.54 Median $398.11 Typical High $891.25 | Professional | 26 · Professional part | $371.54 | $398.11 | $891.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,380.38 Typical High $4,466.84 | Professional | 50 · Both sides | $1,122.02 | $1,380.38 | $4,466.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $457.09 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $371.54 | $457.09 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $186.21 Typical High $588.84 | Professional | 80 · Assistant surgeon | $147.91 | $186.21 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $128.82 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $104.71 | $128.82 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $128.82 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $128.82 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $416.87 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $416.87 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | SH · Second concurrent infusion | $371.54 | $371.54 | $371.54 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | SJ · Third+ concurrent infusion | $371.54 | $371.54 | $371.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $549.54 Median $588.84 Typical High $1,318.26 | Professional | TC · Technical part | $549.54 | $588.84 | $1,318.26 |
Where North Carolina sits
The same service costs 5.4 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· 17th of 51
$1,000
HI $3,236DE $603
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.