How much rates vary
Facilitymedian $339 · 10th to 90th $174 to $479Professionalmedian $417 · 10th to 90th $251 to $479
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $478.63 Typical High $478.63 | Professional | None (both parts) | $269.15 | $478.63 | $478.63 |
BCBS North Carolina Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $537.03 | Facility | None | $457.09 | $457.09 | $537.03 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $316.23 Median $416.87 Typical High $562.34 | Professional | None (both parts) | $316.23 | $416.87 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $245.47 Median $338.84 Typical High $338.84 | Professional | None (both parts) | $245.47 | $338.84 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $354.81 | Professional | None | $295.12 | $316.23 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $524.81 | Facility | None | $173.78 | $302.00 | $524.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $309.03 Median $389.05 Typical High $660.69 | Professional | None (both parts) | $309.03 | $389.05 | $660.69 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Facility | None | $354.81 | $354.81 | $407.38 |
United Setting Professional Modifier None (both parts) Typical Low $204.17 Median $269.15 Typical High $363.08 | Professional | None (both parts) | $204.17 | $269.15 | $363.08 |
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 $134.90 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $134.90 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $53.70 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $40.74 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $47.86 | $47.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $154.88 Median $165.96 Typical High $371.54 | Professional | 26 · Professional part | $154.88 | $165.96 | $371.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $575.44 Typical High $1,862.09 | Professional | 50 · Both sides | $457.09 | $575.44 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $154.88 Median $190.55 Typical High $616.60 | Professional | 51 · Multiple procedures | $154.88 | $190.55 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $77.62 Typical High $245.47 | Professional | 80 · Assistant surgeon | $61.66 | $77.62 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $53.70 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $42.66 | $53.70 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $53.70 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $53.70 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $53.70 Typical High $173.78 | Professional | AS · PA/NP assist | $42.66 | $53.70 | $173.78 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | SH · Second concurrent infusion | $154.88 | $154.88 | $154.88 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | SJ · Third+ concurrent infusion | $154.88 | $154.88 | $154.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $245.47 Typical High $549.54 | Professional | TC · Technical part | $229.09 | $245.47 | $549.54 |
Where North Carolina sits
The same service costs 4.2 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
$417
HI $1,023DE $245
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.