How much rates vary
Facilitymedian $955 · 10th to 90th $501 to $1,148Professionalmedian $1,175 · 10th to 90th $724 to $1,288
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | None (both parts) | $812.83 | $1,148.15 | $1,148.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Facility | None | $1,258.93 | $1,258.93 | $1,513.56 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,174.90 Typical High $1,584.89 | Professional | None (both parts) | $891.25 | $1,174.90 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None (both parts) Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None (both parts) | $707.95 | $954.99 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,023.29 | Professional | None | $794.33 | $870.96 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $1,258.93 | Facility | None | $501.19 | $831.76 | $1,258.93 |
Medcost Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,071.52 Typical High $1,862.09 | Professional | None (both parts) | $870.96 | $1,071.52 | $1,862.09 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $1,023.29 | Facility | None | $173.78 | $173.78 | $1,023.29 |
United Setting Professional Modifier None (both parts) Typical Low $588.84 Median $776.25 Typical High $1,148.15 | Professional | None (both parts) | $588.84 | $776.25 | $1,148.15 |
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 $407.38 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $407.38 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $114.82 | $114.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $436.52 Median $467.74 Typical High $1,047.13 | Professional | 26 · Professional part | $436.52 | $467.74 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,621.81 Typical High $5,248.07 | Professional | 50 · Both sides | $1,288.25 | $1,621.81 | $5,248.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $537.03 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $436.52 | $537.03 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $218.78 Typical High $691.83 | Professional | 80 · Assistant surgeon | $173.78 | $218.78 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $151.36 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $120.23 | $151.36 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $151.36 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $151.36 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $489.78 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $489.78 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | SH · Second concurrent infusion | $436.52 | $436.52 | $436.52 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | SJ · Third+ concurrent infusion | $436.52 | $436.52 | $436.52 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $645.65 Median $691.83 Typical High $1,548.82 | Professional | TC · Technical part | $645.65 | $691.83 | $1,548.82 |
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· 25th of 51
$1,148
HI $2,239DE $708
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.