How much rates vary
Facilitymedian $490 · 10th to 90th $209 to $490Professionalmedian $501 · 10th to 90th $324 to $550
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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $363.08 | $489.78 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $645.65 | Facility | None | $537.03 | $537.03 | $645.65 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $380.19 Median $501.19 Typical High $660.69 | Professional | None (both parts) | $380.19 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $354.81 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $354.81 | $489.78 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $512.86 | Professional | None | $407.38 | $436.52 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $354.81 Typical High $537.03 | Facility | None | $208.93 | $354.81 | $537.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $371.54 Median $457.09 Typical High $794.33 | Professional | None (both parts) | $371.54 | $457.09 | $794.33 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $323.59 | Facility | None | $165.96 | $165.96 | $323.59 |
United Setting Professional Modifier None (both parts) Typical Low $251.19 Median $323.59 Typical High $489.78 | Professional | None (both parts) | $251.19 | $323.59 | $489.78 |
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 $186.21 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $48.98 | $48.98 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $194.98 Typical High $436.52 | Professional | 26 · Professional part | $181.97 | $194.98 | $436.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $691.83 Typical High $2,238.72 | Professional | 50 · Both sides | $549.54 | $691.83 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $229.09 Typical High $741.31 | Professional | 51 · Multiple procedures | $181.97 | $229.09 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $91.20 Typical High $295.12 | Professional | 80 · Assistant surgeon | $74.13 | $91.20 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $64.57 Typical High $208.93 | Professional | AS · PA/NP assist | $51.29 | $64.57 | $208.93 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | SH · Second concurrent infusion | $181.97 | $181.97 | $181.97 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | SJ · Third+ concurrent infusion | $181.97 | $181.97 | $181.97 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $295.12 Typical High $660.69 | Professional | TC · Technical part | $275.42 | $295.12 | $660.69 |
Where North Carolina sits
The same service costs 2.4 times more in Iowa than in Kansas. 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
$490
IA $776KS $324
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.