How much rates vary
Facilitymedian $1,479 · 10th to 90th $589 to $1,585Professionalmedian $1,549 · 10th to 90th $955 to $1,698
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $954.99 | $1,479.11 | $1,479.11 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,548.82 Typical High $2,041.74 | Professional | None (both parts) | $1,174.90 | $1,548.82 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,584.89 Typical High $1,584.89 | Professional | None (both parts) | $1,148.15 | $1,584.89 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,096.48 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,621.81 | Facility | None | $588.84 | $1,096.48 | $1,621.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,412.54 Typical High $2,398.83 | Professional | None (both parts) | $1,122.02 | $1,412.54 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Facility | None | $1,202.26 | $1,202.26 | $1,258.93 |
United Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,000.00 Typical High $1,412.54 | Professional | None (both parts) | $758.58 | $1,000.00 | $1,412.54 |
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 $478.63 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $478.63 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $190.55 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $95.50 | $147.91 | $147.91 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $562.34 Median $602.56 Typical High $1,348.96 | Professional | 26 · Professional part | $562.34 | $602.56 | $1,348.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,089.30 Typical High $6,760.83 | Professional | 50 · Both sides | $1,698.24 | $2,089.30 | $6,760.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $707.95 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $562.34 | $707.95 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $281.84 Typical High $912.01 | Professional | 80 · Assistant surgeon | $223.87 | $281.84 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $194.98 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $158.49 | $194.98 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $194.98 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $194.98 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $194.98 Typical High $630.96 | Professional | AS · PA/NP assist | $158.49 | $194.98 | $630.96 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | SH · Second concurrent infusion | $562.34 | $562.34 | $562.34 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | SJ · Third+ concurrent infusion | $562.34 | $562.34 | $562.34 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $851.14 Median $912.01 Typical High $2,041.74 | Professional | TC · Technical part | $851.14 | $912.01 | $2,041.74 |
Where North Carolina sits
The same service costs 2.8 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
$1,549
HI $2,692DC $977
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.