How much rates vary
Facilitymedian $372 · 10th to 90th $182 to $575Professionalmedian $501 · 10th to 90th $302 to $575
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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $575.44 Typical High $575.44 | Professional | None (both parts) | $309.03 | $575.44 | $575.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $645.65 | Facility | None | $537.03 | $537.03 | $645.65 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $380.19 Median $501.19 Typical High $676.08 | Professional | None (both parts) | $380.19 | $501.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $371.54 Typical High $371.54 | Professional | None (both parts) | $275.42 | $371.54 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $380.19 | Professional | None | $302.00 | $323.59 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $354.81 Typical High $630.96 | Facility | None | $181.97 | $354.81 | $630.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $371.54 Median $457.09 Typical High $794.33 | Professional | None (both parts) | $371.54 | $457.09 | $794.33 |
United Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
United Setting Professional Modifier None (both parts) Typical Low $218.78 Median $316.23 Typical High $416.87 | Professional | None (both parts) | $218.78 | $316.23 | $416.87 |
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 $154.88 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $154.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $63.10 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $46.77 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $30.90 | $57.54 | $57.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $199.53 Typical High $446.68 | Professional | 26 · Professional part | $186.21 | $199.53 | $446.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $691.83 Typical High $2,238.72 | Professional | 50 · Both sides | $549.54 | $691.83 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $229.09 Typical High $741.31 | Professional | 51 · Multiple procedures | $186.21 | $229.09 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $93.33 Typical High $295.12 | Professional | 80 · Assistant surgeon | $74.13 | $93.33 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | AS · PA/NP assist | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | SH · Second concurrent infusion | $186.21 | $186.21 | $186.21 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | SJ · Third+ concurrent infusion | $186.21 | $186.21 | $186.21 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $295.12 Typical High $660.69 | Professional | TC · Technical part | $275.42 | $295.12 | $660.69 |
Where North Carolina sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$501
HI $813VT $275
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.