How much rates vary
Facilitymedian $741 · 10th to 90th $380 to $1,023Professionalmedian $912 · 10th to 90th $550 to $1,023
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | None (both parts) | $588.84 | $1,023.29 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Facility | None | $977.24 | $977.24 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $691.83 Median $912.01 Typical High $1,202.26 | Professional | None (both parts) | $691.83 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | None (both parts) | $537.03 | $741.31 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | None | $724.44 | $794.33 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $645.65 Typical High $1,148.15 | Facility | None | $380.19 | $645.65 | $1,148.15 |
Medcost Setting Professional Modifier None (both parts) Typical Low $660.69 Median $831.76 Typical High $1,380.38 | Professional | None (both parts) | $660.69 | $831.76 | $1,380.38 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Facility | None | $776.25 | $776.25 | $912.01 |
United Setting Professional Modifier None (both parts) Typical Low $457.09 Median $588.84 Typical High $831.76 | Professional | None (both parts) | $457.09 | $588.84 | $831.76 |
15 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 $302.00 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $302.00 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $120.23 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $91.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $60.26 | $102.33 | $102.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $331.13 Median $354.81 Typical High $794.33 | Professional | 26 · Professional part | $331.13 | $354.81 | $794.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,230.27 Typical High $3,981.07 | Professional | 50 · Both sides | $1,000.00 | $1,230.27 | $3,981.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $416.87 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $331.13 | $416.87 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $165.96 Typical High $537.03 | Professional | 80 · Assistant surgeon | $131.83 | $165.96 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $114.82 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $93.33 | $114.82 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $114.82 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $114.82 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $114.82 Typical High $371.54 | Professional | AS · PA/NP assist | $93.33 | $114.82 | $371.54 |
Medcost Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | RR · Rental | $66.07 | $66.07 | $66.07 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | SH · Second concurrent infusion | $331.13 | $331.13 | $331.13 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | SJ · Third+ concurrent infusion | $331.13 | $331.13 | $331.13 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $501.19 Median $537.03 Typical High $1,202.26 | Professional | TC · Technical part | $501.19 | $537.03 | $1,202.26 |
Where North Carolina sits
The same service costs 4.6 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· 20th of 51
$912
HI $2,455DE $537
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.