How much rates vary
Facilitymedian $407 · 10th to 90th $209 to $617Professionalmedian $537 · 10th to 90th $316 to $617
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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None (both parts) Typical Low $346.74 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $346.74 | $616.60 | $616.60 |
BCBS North Carolina Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $691.83 | Facility | None | $575.44 | $575.44 | $691.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $407.38 Median $537.03 Typical High $724.44 | Professional | None (both parts) | $407.38 | $537.03 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | None (both parts) | $295.12 | $407.38 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $436.52 | Professional | None | $338.84 | $371.54 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $676.08 | Facility | None | $208.93 | $380.19 | $676.08 |
Medcost Setting Professional Modifier None (both parts) Typical Low $398.11 Median $489.78 Typical High $851.14 | Professional | None (both parts) | $398.11 | $489.78 | $851.14 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None (both parts) Typical Low $251.19 Median $346.74 Typical High $467.74 | Professional | None (both parts) | $251.19 | $346.74 | $467.74 |
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 $173.78 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $173.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $69.18 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $52.48 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $34.67 | $61.66 | $61.66 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $213.80 Typical High $467.74 | Professional | 26 · Professional part | $199.53 | $213.80 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $741.31 Typical High $2,398.83 | Professional | 50 · Both sides | $588.84 | $741.31 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $245.47 Typical High $794.33 | Professional | 51 · Multiple procedures | $199.53 | $245.47 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $97.72 Typical High $316.23 | Professional | 80 · Assistant surgeon | $79.43 | $97.72 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $69.18 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $54.95 | $69.18 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $69.18 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $69.18 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $69.18 Typical High $223.87 | Professional | AS · PA/NP assist | $54.95 | $69.18 | $223.87 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | SH · Second concurrent infusion | $199.53 | $199.53 | $199.53 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | SJ · Third+ concurrent infusion | $199.53 | $199.53 | $199.53 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $295.12 Median $316.23 Typical High $707.95 | Professional | TC · Technical part | $295.12 | $316.23 | $707.95 |
Where North Carolina sits
The same service costs 4.3 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· 17th of 51
$537
HI $1,259DE $295
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.