How much rates vary
Facilitymedian $912 · 10th to 90th $468 to $1,230Professionalmedian $1,259 · 10th to 90th $759 to $1,380
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,230.27 Typical High $1,230.27 | Professional | None (both parts) | $758.58 | $1,230.27 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,348.96 | $1,348.96 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,258.93 Typical High $1,659.59 | Professional | None (both parts) | $954.99 | $1,258.93 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Professional Modifier None (both parts) Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | None (both parts) | $660.69 | $912.01 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $954.99 | Professional | None | $794.33 | $851.14 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $891.25 Typical High $1,348.96 | Facility | None | $467.74 | $891.25 | $1,348.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $912.01 Median $1,148.15 Typical High $1,949.84 | Professional | None (both parts) | $912.01 | $1,148.15 | $1,949.84 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
United Setting Professional Modifier None (both parts) Typical Low $616.60 Median $812.83 Typical High $1,122.02 | Professional | None (both parts) | $616.60 | $812.83 | $1,122.02 |
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 $380.19 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $380.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $151.36 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $75.86 | $123.03 | $123.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $457.09 Median $489.78 Typical High $1,096.48 | Professional | 26 · Professional part | $457.09 | $489.78 | $1,096.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,737.80 Typical High $5,495.41 | Professional | 50 · Both sides | $1,380.38 | $1,737.80 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $575.44 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $457.09 | $575.44 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $229.09 Typical High $741.31 | Professional | 80 · Assistant surgeon | $181.97 | $229.09 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $162.18 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $128.82 | $162.18 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $162.18 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $162.18 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $512.86 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $512.86 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | SH · Second concurrent infusion | $457.09 | $457.09 | $457.09 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | SJ · Third+ concurrent infusion | $457.09 | $457.09 | $457.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $691.83 Median $741.31 Typical High $1,659.59 | Professional | TC · Technical part | $691.83 | $741.31 | $1,659.59 |
Where North Carolina sits
The same service costs 3.2 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· 16th of 51
$1,230
HI $2,138DE $661
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.