How much rates vary
Facilitymedian $1,738 · 10th to 90th $891 to $2,138Professionalmedian $2,188 · 10th to 90th $1,380 to $2,188
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $1,513.56 | $2,137.96 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,187.76 Typical High $2,187.76 | Professional | None (both parts) | $1,905.46 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $1,737.80 Typical High $1,778.28 | Professional | None (both parts) | $1,258.93 | $1,737.80 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,698.24 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,344.23 | Facility | None | $891.25 | $1,584.89 | $2,344.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,041.74 Typical High $3,467.37 | Professional | None (both parts) | $1,621.81 | $2,041.74 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,445.44 | $1,621.81 |
United Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,445.44 Typical High $2,089.30 | Professional | None (both parts) | $1,096.48 | $1,445.44 | $2,089.30 |
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 $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $758.58 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $151.36 | $213.80 | $213.80 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $812.83 Median $870.96 Typical High $1,949.84 | Professional | 26 · Professional part | $812.83 | $870.96 | $1,949.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,019.95 Typical High $9,772.37 | Professional | 50 · Both sides | $2,454.71 | $3,019.95 | $9,772.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $1,023.29 Typical High $3,235.94 | Professional | 51 · Multiple procedures | $812.83 | $1,023.29 | $3,235.94 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $407.38 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $323.59 | $407.38 | $1,318.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $281.84 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $229.09 | $281.84 | $912.01 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $281.84 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $281.84 | $912.01 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $281.84 Typical High $912.01 | Professional | AS · PA/NP assist | $229.09 | $281.84 | $912.01 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | SH · Second concurrent infusion | $812.83 | $812.83 | $812.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | SJ · Third+ concurrent infusion | $812.83 | $812.83 | $812.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,230.27 Median $1,288.25 Typical High $2,884.03 | Professional | TC · Technical part | $1,230.27 | $1,288.25 | $2,884.03 |
Where North Carolina sits
The same service costs 2.7 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· 17th of 51
$2,188
HI $3,388DE $1,259
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.