How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,995 to $5,248Professionalmedian $4,786 · 10th to 90th $3,090 to $5,248
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 $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,235.94 Median $4,570.88 Typical High $4,570.88 | Professional | None (both parts) | $3,235.94 | $4,570.88 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $3,630.78 Median $4,786.30 Typical High $6,309.57 | Professional | None (both parts) | $3,630.78 | $4,786.30 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Professional Modifier None (both parts) Typical Low $3,548.13 Median $4,897.79 Typical High $4,897.79 | Professional | None (both parts) | $3,548.13 | $4,897.79 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $4,168.69 | Professional | None | $3,019.95 | $3,235.94 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $5,128.61 | Facility | None | $1,995.26 | $3,388.44 | $5,128.61 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $4,365.16 Typical High $7,413.10 | Professional | None (both parts) | $3,467.37 | $4,365.16 | $7,413.10 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,370.32 | Facility | None | $4,073.80 | $4,073.80 | $5,370.32 |
United Setting Professional Modifier None (both parts) Typical Low $2,398.83 Median $3,090.30 Typical High $4,677.35 | Professional | None (both parts) | $2,398.83 | $3,090.30 | $4,677.35 |
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 $1,621.81 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,621.81 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $645.65 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $323.59 | $457.09 | $457.09 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,737.80 Median $1,862.09 Typical High $4,168.69 | Professional | 26 · Professional part | $1,737.80 | $1,862.09 | $4,168.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,248.07 Median $6,456.54 Typical High $20,892.96 | Professional | 50 · Both sides | $5,248.07 | $6,456.54 | $20,892.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,737.80 Median $2,187.76 Typical High $7,079.46 | Professional | 51 · Multiple procedures | $1,737.80 | $2,187.76 | $7,079.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $870.96 Typical High $2,818.38 | Professional | 80 · Assistant surgeon | $691.83 | $870.96 | $2,818.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $489.78 Median $602.56 Typical High $1,949.84 | Professional | 81 · Minimal assistant surgeon | $489.78 | $602.56 | $1,949.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $489.78 Median $602.56 Typical High $1,949.84 | Professional | 82 · Assistant surgeon, no resident | $489.78 | $602.56 | $1,949.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $602.56 Typical High $1,949.84 | Professional | AS · PA/NP assist | $489.78 | $602.56 | $1,949.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | SH · Second concurrent infusion | $1,737.80 | $1,737.80 | $1,737.80 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | SJ · Third+ concurrent infusion | $1,737.80 | $1,737.80 | $1,737.80 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,630.27 Median $2,818.38 Typical High $6,309.57 | Professional | TC · Technical part | $2,630.27 | $2,818.38 | $6,309.57 |
Where North Carolina sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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
$4,786
HI $11,482DC $3,311
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.