How much rates vary
Facilitymedian $1,318 · 10th to 90th $676 to $1,820Professionalmedian $1,585 · 10th to 90th $955 to $1,820
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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,819.70 Typical High $1,819.70 | Professional | None (both parts) | $1,047.13 | $1,819.70 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Facility | None | $1,737.80 | $1,737.80 | $2,089.30 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,584.89 Typical High $2,137.96 | Professional | None (both parts) | $1,202.26 | $1,584.89 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | None (both parts) | $954.99 | $1,318.26 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,096.48 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,148.15 Typical High $1,995.26 | Facility | None | $676.08 | $1,148.15 | $1,995.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,479.11 Typical High $2,511.89 | Professional | None (both parts) | $1,174.90 | $1,479.11 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,122.02 | $1,122.02 | $1,258.93 |
United Setting Professional Modifier None (both parts) Typical Low $794.33 Median $1,047.13 Typical High $1,479.11 | Professional | None (both parts) | $794.33 | $1,047.13 | $1,479.11 |
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 $537.03 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $537.03 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $213.80 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $162.18 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $107.15 | $181.97 | $181.97 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $588.84 Median $630.96 Typical High $1,412.54 | Professional | 26 · Professional part | $588.84 | $630.96 | $1,412.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,187.76 Typical High $7,079.46 | Professional | 50 · Both sides | $1,778.28 | $2,187.76 | $7,079.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $741.31 Typical High $2,344.23 | Professional | 51 · Multiple procedures | $588.84 | $741.31 | $2,344.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $295.12 Typical High $933.25 | Professional | 80 · Assistant surgeon | $234.42 | $295.12 | $933.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $204.17 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $165.96 | $204.17 | $660.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $204.17 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $204.17 | $660.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $660.69 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $660.69 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | SH · Second concurrent infusion | $588.84 | $588.84 | $588.84 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | SJ · Third+ concurrent infusion | $588.84 | $588.84 | $588.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $933.25 Typical High $2,089.30 | Professional | TC · Technical part | $870.96 | $933.25 | $2,089.30 |
Where North Carolina sits
The same service costs 2.9 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· 19th of 51
$1,585
HI $2,754DE $955
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.