How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,047 to $3,467Professionalmedian $3,020 · 10th to 90th $1,778 to $3,467
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 $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $3,467.37 Typical High $3,467.37 | Professional | None (both parts) | $1,862.09 | $3,467.37 | $3,467.37 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,890.45 | Facility | None | $3,235.94 | $3,235.94 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $3,019.95 Typical High $3,235.94 | Professional | None (both parts) | $2,570.40 | $3,019.95 | $3,235.94 |
Cigna 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 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,995.26 Typical High $1,995.26 | Professional | None (both parts) | $1,479.11 | $1,995.26 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,621.81 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $2,137.96 Typical High $3,467.37 | Facility | None | $1,047.13 | $2,137.96 | $3,467.37 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $2,754.23 Typical High $4,677.35 | Professional | None (both parts) | $2,187.76 | $2,754.23 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Facility | None | $2,137.96 | $2,137.96 | $2,951.21 |
United Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,862.09 Typical High $2,454.71 | Professional | None (both parts) | $1,318.26 | $1,862.09 | $2,454.71 |
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 $954.99 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $954.99 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $380.19 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $288.40 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $190.55 | $346.74 | $346.74 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,096.48 Median $1,174.90 Typical High $2,630.27 | Professional | 26 · Professional part | $1,096.48 | $1,174.90 | $2,630.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,311.31 Median $4,168.69 Typical High $13,182.57 | Professional | 50 · Both sides | $3,311.31 | $4,168.69 | $13,182.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,380.38 Typical High $4,466.84 | Professional | 51 · Multiple procedures | $1,096.48 | $1,380.38 | $4,466.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $549.54 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $446.68 | $549.54 | $1,778.28 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $389.05 Typical High $1,230.27 | Professional | 81 · Minimal assistant surgeon | $309.03 | $389.05 | $1,230.27 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $389.05 Typical High $1,230.27 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $389.05 | $1,230.27 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $389.05 Typical High $1,230.27 | Professional | AS · PA/NP assist | $309.03 | $389.05 | $1,230.27 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | SH · Second concurrent infusion | $1,096.48 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | SJ · Third+ concurrent infusion | $1,096.48 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,659.59 Median $1,778.28 Typical High $3,981.07 | Professional | TC · Technical part | $1,659.59 | $1,778.28 | $3,981.07 |
Where North Carolina sits
The same service costs 4.4 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· 11th of 51
$3,020
HI $6,457DE $1,479
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.