How much rates vary
Facilitymedian $891 · 10th to 90th $447 to $1,549Professionalmedian $1,349 · 10th to 90th $794 to $1,549
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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,548.82 Typical High $1,548.82 | Professional | None (both parts) | $812.83 | $1,548.82 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Facility | None | $1,479.11 | $1,479.11 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,348.96 Typical High $1,819.70 | Professional | None (both parts) | $1,047.13 | $1,348.96 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $645.65 Median $891.25 Typical High $912.01 | Professional | None (both parts) | $645.65 | $891.25 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $977.24 | Professional | None | $645.65 | $691.83 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,548.82 | Facility | None | $446.68 | $977.24 | $1,548.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,258.93 Typical High $2,137.96 | Professional | None (both parts) | $1,000.00 | $1,258.93 | $2,137.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Facility | None | $851.14 | $851.14 | $870.96 |
United Setting Professional Modifier None (both parts) Typical Low $588.84 Median $851.14 Typical High $1,047.13 | Professional | None (both parts) | $588.84 | $851.14 | $1,047.13 |
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 $426.58 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $426.58 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $169.82 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $125.89 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $85.11 | $154.88 | $154.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $501.19 Median $537.03 Typical High $1,202.26 | Professional | 26 · Professional part | $501.19 | $537.03 | $1,202.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $6,025.60 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $6,025.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $630.96 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $501.19 | $630.96 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $251.19 Typical High $812.83 | Professional | 80 · Assistant surgeon | $199.53 | $251.19 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $173.78 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $141.25 | $173.78 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $173.78 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $173.78 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $562.34 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $562.34 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | SH · Second concurrent infusion | $501.19 | $501.19 | $501.19 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | SJ · Third+ concurrent infusion | $501.19 | $501.19 | $501.19 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $758.58 Median $794.33 Typical High $1,778.28 | Professional | TC · Technical part | $758.58 | $794.33 | $1,778.28 |
Where North Carolina sits
The same service costs 3.0 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· 10th of 51
$1,349
HI $1,905DE $646
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.