How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,479 to $3,388Professionalmedian $3,467 · 10th to 90th $2,138 to $3,802
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 $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,344.23 Median $3,388.44 Typical High $3,388.44 | Professional | None (both parts) | $2,344.23 | $3,388.44 | $3,388.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,570.88 | Facility | None | $3,801.89 | $3,801.89 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $3,467.37 Typical High $4,677.35 | Professional | None (both parts) | $2,630.27 | $3,467.37 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,884.03 Typical High $2,884.03 | Professional | None (both parts) | $2,089.30 | $2,884.03 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,344.23 | $2,511.89 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $3,715.35 | Facility | None | $1,479.11 | $2,511.89 | $3,715.35 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $3,235.94 Typical High $5,495.41 | Professional | None (both parts) | $2,570.40 | $3,235.94 | $5,495.41 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,090.30 | Facility | None | $3,019.95 | $3,019.95 | $3,090.30 |
United Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,290.87 Typical High $3,467.37 | Professional | None (both parts) | $1,737.80 | $2,290.87 | $3,467.37 |
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 $1,202.26 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,202.26 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $478.63 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $363.08 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $239.88 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,288.25 Median $1,380.38 Typical High $3,090.30 | Professional | 26 · Professional part | $1,288.25 | $1,380.38 | $3,090.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,890.45 Median $4,786.30 Typical High $15,488.17 | Professional | 50 · Both sides | $3,890.45 | $4,786.30 | $15,488.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,584.89 Typical High $5,128.61 | Professional | 51 · Multiple procedures | $1,288.25 | $1,584.89 | $5,128.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $645.65 Typical High $2,041.74 | Professional | 80 · Assistant surgeon | $512.86 | $645.65 | $2,041.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $446.68 Typical High $1,445.44 | Professional | 81 · Minimal assistant surgeon | $363.08 | $446.68 | $1,445.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $446.68 Typical High $1,445.44 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $446.68 | $1,445.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $446.68 Typical High $1,445.44 | Professional | AS · PA/NP assist | $363.08 | $446.68 | $1,445.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | SH · Second concurrent infusion | $1,288.25 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | SJ · Third+ concurrent infusion | $1,288.25 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,905.46 Median $2,041.74 Typical High $4,570.88 | Professional | TC · Technical part | $1,905.46 | $2,041.74 | $4,570.88 |
Where North Carolina sits
The same service costs 3.4 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· 19th of 51
$3,467
HI $7,079DE $2,089
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.