How much rates vary
Facilitymedian $490 · 10th to 90th $257 to $832Professionalmedian $724 · 10th to 90th $427 to $832
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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None (both parts) Typical Low $446.68 Median $831.76 Typical High $831.76 | Professional | None (both parts) | $446.68 | $831.76 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $933.25 | Facility | None | $776.25 | $776.25 | $933.25 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $616.60 Median $724.44 Typical High $776.25 | Professional | None (both parts) | $616.60 | $724.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $489.78 Typical High $512.86 | Professional | None (both parts) | $363.08 | $489.78 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $524.81 | Professional | None | $371.54 | $398.11 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $512.86 Typical High $831.76 | Facility | None | $257.04 | $512.86 | $831.76 |
Medcost Setting Professional Modifier None (both parts) Typical Low $537.03 Median $660.69 Typical High $1,148.15 | Professional | None (both parts) | $537.03 | $660.69 | $1,148.15 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Facility | None | $478.63 | $478.63 | $524.81 |
United Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $588.84 | Professional | None (both parts) | $316.23 | $457.09 | $588.84 |
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 $223.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $223.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $89.13 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $67.61 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $44.67 | $83.18 | $83.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $281.84 Typical High $630.96 | Professional | 26 · Professional part | $263.03 | $281.84 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $3,235.94 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $3,235.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $331.13 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $263.03 | $331.13 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $131.83 Typical High $426.58 | Professional | 80 · Assistant surgeon | $107.15 | $131.83 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $93.33 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $74.13 | $93.33 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $93.33 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $93.33 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $93.33 Typical High $302.00 | Professional | AS · PA/NP assist | $74.13 | $93.33 | $302.00 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | SH · Second concurrent infusion | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | SJ · Third+ concurrent infusion | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $398.11 Median $426.58 Typical High $954.99 | Professional | TC · Technical part | $398.11 | $426.58 | $954.99 |
Where North Carolina sits
The same service costs 3.2 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· 15th of 51
$724
HI $1,175DE $363
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.