How much rates vary
Facilitymedian $347 · 10th to 90th $141 to $389Professionalmedian $339 · 10th to 90th $219 to $389
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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None (both parts) Typical Low $239.88 Median $389.05 Typical High $389.05 | Professional | None (both parts) | $239.88 | $389.05 | $389.05 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None (both parts) | $407.38 | $407.38 | $407.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $436.52 | Facility | None | $363.08 | $363.08 | $436.52 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $323.59 Median $338.84 Typical High $446.68 | Professional | None (both parts) | $323.59 | $338.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | None (both parts) | $251.19 | $346.74 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $323.59 | Professional | None | $218.78 | $234.42 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $426.58 | Facility | None | $141.25 | $239.88 | $426.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $309.03 Typical High $537.03 | Professional | None (both parts) | $251.19 | $309.03 | $537.03 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $389.05 | Facility | None | $295.12 | $295.12 | $389.05 |
United Setting Professional Modifier None (both parts) Typical Low $169.82 Median $218.78 Typical High $309.03 | Professional | None (both parts) | $169.82 | $218.78 | $309.03 |
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 $117.49 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $117.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $38.90 | $38.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $123.03 Median $131.83 Typical High $295.12 | Professional | 26 · Professional part | $123.03 | $131.83 | $295.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $467.74 Typical High $1,513.56 | Professional | 50 · Both sides | $371.54 | $467.74 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $154.88 Typical High $501.19 | Professional | 51 · Multiple procedures | $125.89 | $154.88 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $61.66 Typical High $199.53 | Professional | 80 · Assistant surgeon | $50.12 | $61.66 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $43.65 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $34.67 | $43.65 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $43.65 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $43.65 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $43.65 Typical High $141.25 | Professional | AS · PA/NP assist | $34.67 | $43.65 | $141.25 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SH · Second concurrent infusion | $125.89 | $125.89 | $125.89 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SJ · Third+ concurrent infusion | $125.89 | $125.89 | $125.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $186.21 Median $199.53 Typical High $446.68 | Professional | TC · Technical part | $186.21 | $199.53 | $446.68 |
Where North Carolina sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 23rd of 51
$339
HI $912FL $240
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.