How much rates vary
Facilitymedian $1,175 · 10th to 90th $603 to $1,995Professionalmedian $1,738 · 10th to 90th $1,000 to $1,995
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,995.26 Typical High $1,995.26 | Professional | None (both parts) | $1,047.13 | $1,995.26 | $1,995.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Facility | None | $1,862.09 | $1,862.09 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,737.80 Typical High $2,344.23 | Professional | None (both parts) | $1,318.26 | $1,737.80 | $2,344.23 |
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 $954.99 Typical High $1,348.96 | Professional | None | $870.96 | $954.99 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,995.26 | Facility | None | $602.56 | $1,230.27 | $1,995.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,584.89 Typical High $2,754.23 | Professional | None (both parts) | $1,288.25 | $1,584.89 | $2,754.23 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
United Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,096.48 Typical High $1,412.54 | Professional | None (both parts) | $758.58 | $1,096.48 | $1,412.54 |
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 $537.03 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $537.03 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $213.80 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $162.18 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $107.15 | $199.53 | $199.53 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $630.96 Median $676.08 Typical High $1,513.56 | Professional | 26 · Professional part | $630.96 | $676.08 | $1,513.56 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,398.83 Typical High $7,762.47 | Professional | 50 · Both sides | $1,905.46 | $2,398.83 | $7,762.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $794.33 Typical High $2,570.40 | Professional | 51 · Multiple procedures | $645.65 | $794.33 | $2,570.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $316.23 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $257.04 | $316.23 | $1,023.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $223.87 Typical High $724.44 | Professional | 81 · Minimal assistant surgeon | $177.83 | $223.87 | $724.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $223.87 Typical High $724.44 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $223.87 | $724.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $223.87 Typical High $724.44 | Professional | AS · PA/NP assist | $177.83 | $223.87 | $724.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | SH · Second concurrent infusion | $645.65 | $645.65 | $645.65 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | SJ · Third+ concurrent infusion | $645.65 | $645.65 | $645.65 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $954.99 Median $1,023.29 Typical High $2,290.87 | Professional | TC · Technical part | $954.99 | $1,023.29 | $2,290.87 |
Where North Carolina sits
The same service costs 3.0 times more in Montana 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· 14th of 51
$1,738
MT $2,570DE $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.