How much rates vary
Facilitymedian $3,020 · 10th to 90th $2,884 to $3,548Professionalmedian $3,631 · 10th to 90th $2,239 to $3,981
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 $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $3,548.13 Typical High $3,548.13 | Professional | None (both parts) | $2,137.96 | $3,548.13 | $3,548.13 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,630.78 Typical High $4,786.30 | Professional | None (both parts) | $3,467.37 | $3,630.78 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $3,019.95 Typical High $3,019.95 | Professional | None (both parts) | $2,187.76 | $3,019.95 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,548.13 | $4,265.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3,630.78 Median $3,630.78 Typical High $5,754.40 | Professional | None (both parts) | $3,630.78 | $3,630.78 | $5,754.40 |
United Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,344.23 Typical High $3,162.28 | Professional | None (both parts) | $1,819.70 | $2,344.23 | $3,162.28 |
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 $1,047.13 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,047.13 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $426.58 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $316.23 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $213.80 | $354.81 | $354.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,479.11 Median $1,479.11 Typical High $3,162.28 | Professional | 26 · Professional part | $1,479.11 | $1,479.11 | $3,162.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,495.41 Median $5,495.41 Typical High $15,848.93 | Professional | 50 · Both sides | $5,495.41 | $5,495.41 | $15,848.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,819.70 Median $1,819.70 Typical High $5,370.32 | Professional | 51 · Multiple procedures | $1,819.70 | $1,819.70 | $5,370.32 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $724.44 Typical High $2,137.96 | Professional | 80 · Assistant surgeon | $724.44 | $724.44 | $2,137.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $512.86 Median $512.86 Typical High $1,479.11 | Professional | 81 · Minimal assistant surgeon | $512.86 | $512.86 | $1,479.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $512.86 Median $512.86 Typical High $1,479.11 | Professional | 82 · Assistant surgeon, no resident | $512.86 | $512.86 | $1,479.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $512.86 Typical High $1,479.11 | Professional | AS · PA/NP assist | $512.86 | $512.86 | $1,479.11 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | SH · Second concurrent infusion | $1,819.70 | $1,819.70 | $1,819.70 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | SJ · Third+ concurrent infusion | $1,819.70 | $1,819.70 | $1,819.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,187.76 Median $2,187.76 Typical High $4,786.30 | Professional | TC · Technical part | $2,187.76 | $2,187.76 | $4,786.30 |
Where North Carolina sits
The same service costs 2.4 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· 17th of 51
$3,631
HI $5,248WV $2,188
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.