How much rates vary
Facilitymedian $1,175 · 10th to 90th $603 to $1,698Professionalmedian $1,479 · 10th to 90th $891 to $1,698
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,698.24 Typical High $1,698.24 | Professional | None (both parts) | $1,000.00 | $1,698.24 | $1,698.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Facility | None | $1,584.89 | $1,584.89 | $1,905.46 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,479.11 Typical High $1,949.84 | Professional | None (both parts) | $1,122.02 | $1,479.11 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $851.14 Median $1,174.90 Typical High $1,174.90 | Professional | None (both parts) | $851.14 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,348.96 | Professional | None | $870.96 | $933.25 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,862.09 | Facility | None | $602.56 | $1,047.13 | $1,862.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,348.96 Typical High $2,290.87 | Professional | None (both parts) | $1,071.52 | $1,348.96 | $2,290.87 |
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 $724.44 Median $954.99 Typical High $1,348.96 | Professional | None (both parts) | $724.44 | $954.99 | $1,348.96 |
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 $501.19 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $501.19 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $199.53 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $151.36 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $100.00 | $169.82 | $169.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $537.03 Median $575.44 Typical High $1,288.25 | Professional | 26 · Professional part | $537.03 | $575.44 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,041.74 Typical High $6,456.54 | Professional | 50 · Both sides | $1,621.81 | $2,041.74 | $6,456.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $676.08 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $537.03 | $676.08 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $870.96 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $190.55 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $151.36 | $190.55 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $190.55 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $190.55 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $190.55 Typical High $602.56 | Professional | AS · PA/NP assist | $151.36 | $190.55 | $602.56 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | SH · Second concurrent infusion | $537.03 | $537.03 | $537.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | SJ · Third+ concurrent infusion | $537.03 | $537.03 | $537.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $812.83 Median $870.96 Typical High $1,949.84 | Professional | TC · Technical part | $812.83 | $870.96 | $1,949.84 |
Where North Carolina sits
The same service costs 3.3 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· 18th of 51
$1,479
HI $2,818DE $851
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.