How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,288 to $3,236Professionalmedian $3,388 · 10th to 90th $2,089 to $3,388
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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $3,235.94 Typical High $3,235.94 | Professional | None (both parts) | $2,089.30 | $3,235.94 | $3,235.94 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $3,388.44 Typical High $3,388.44 | Professional | None (both parts) | $2,884.03 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,995.26 Median $2,754.23 Typical High $2,754.23 | Professional | None (both parts) | $1,995.26 | $2,754.23 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,290.87 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $3,630.78 | Facility | None | $1,288.25 | $2,398.83 | $3,630.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,090.30 Typical High $5,248.07 | Professional | None (both parts) | $2,454.71 | $3,090.30 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Facility | None | $2,187.76 | $2,187.76 | $2,398.83 |
United Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,187.76 Typical High $3,019.95 | Professional | None (both parts) | $1,659.59 | $2,187.76 | $3,019.95 |
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 $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,071.52 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $426.58 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $316.23 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $213.80 | $323.59 | $323.59 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,230.27 Median $1,318.26 Typical High $2,951.21 | Professional | 26 · Professional part | $1,230.27 | $1,318.26 | $2,951.21 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,570.88 Typical High $14,791.08 | Professional | 50 · Both sides | $3,715.35 | $4,570.88 | $14,791.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,548.82 Typical High $5,011.87 | Professional | 51 · Multiple procedures | $1,230.27 | $1,548.82 | $5,011.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $616.60 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $489.78 | $616.60 | $1,995.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $426.58 Typical High $1,380.38 | Professional | 81 · Minimal assistant surgeon | $346.74 | $426.58 | $1,380.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $426.58 Typical High $1,380.38 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $426.58 | $1,380.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $426.58 Typical High $1,380.38 | Professional | AS · PA/NP assist | $346.74 | $426.58 | $1,380.38 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | SH · Second concurrent infusion | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | SJ · Third+ concurrent infusion | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,862.09 Median $1,995.26 Typical High $4,466.84 | Professional | TC · Technical part | $1,862.09 | $1,995.26 | $4,466.84 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in West Virginia. 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· 16th of 51
$3,388
HI $5,129WV $1,995
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.