How much rates vary
Facilitymedian $759 · 10th to 90th $309 to $912Professionalmedian $794 · 10th to 90th $490 to $912
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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None (both parts) Typical Low $524.81 Median $912.01 Typical High $912.01 | Professional | None (both parts) | $524.81 | $912.01 | $912.01 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $794.33 Typical High $1,047.13 | Professional | None (both parts) | $602.56 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | None (both parts) | $549.54 | $758.58 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $707.95 | Professional | None | $524.81 | $562.34 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $1,000.00 | Facility | None | $309.03 | $562.34 | $1,000.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $575.44 Median $724.44 Typical High $1,230.27 | Professional | None (both parts) | $575.44 | $724.44 | $1,230.27 |
United Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $645.65 | Facility | None | $575.44 | $575.44 | $645.65 |
United Setting Professional Modifier None (both parts) Typical Low $371.54 Median $512.86 Typical High $691.83 | Professional | None (both parts) | $371.54 | $512.86 | $691.83 |
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 $263.03 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $263.03 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $104.71 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $77.62 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $52.48 | $91.20 | $91.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $288.40 Median $309.03 Typical High $691.83 | Professional | 26 · Professional part | $288.40 | $309.03 | $691.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $3,467.37 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $3,467.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $363.08 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $288.40 | $363.08 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $467.74 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $81.28 Median $102.33 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $81.28 | $102.33 | $323.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $81.28 Median $102.33 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $81.28 | $102.33 | $323.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $323.59 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $323.59 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | SH · Second concurrent infusion | $288.40 | $288.40 | $288.40 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | SJ · Third+ concurrent infusion | $288.40 | $288.40 | $288.40 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $436.52 Median $467.74 Typical High $1,047.13 | Professional | TC · Technical part | $436.52 | $467.74 | $1,047.13 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 17th of 51
$794
HI $1,445AZ $550
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.