How much rates vary
Facilitymedian $1,585 · 10th to 90th $676 to $1,622Professionalmedian $1,622 · 10th to 90th $1,047 to $1,778
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | None (both parts) | $1,096.48 | $1,584.89 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,621.81 Typical High $2,187.76 | Professional | None (both parts) | $1,230.27 | $1,621.81 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | None (both parts) | $1,174.90 | $1,621.81 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,380.38 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,737.80 | Facility | None | $676.08 | $1,174.90 | $1,737.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,479.11 Typical High $2,570.40 | Professional | None (both parts) | $1,202.26 | $1,479.11 | $2,570.40 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,380.38 | Facility | None | $776.25 | $776.25 | $1,380.38 |
United Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,071.52 Typical High $1,584.89 | Professional | None (both parts) | $812.83 | $1,071.52 | $1,584.89 |
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 $562.34 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $562.34 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $158.49 | $158.49 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $602.56 Median $645.65 Typical High $1,445.44 | Professional | 26 · Professional part | $602.56 | $645.65 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,238.72 Typical High $7,244.36 | Professional | 50 · Both sides | $1,778.28 | $2,238.72 | $7,244.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $741.31 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $602.56 | $741.31 | $2,398.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $302.00 Typical High $954.99 | Professional | 80 · Assistant surgeon | $239.88 | $302.00 | $954.99 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $208.93 Typical High $676.08 | Professional | 81 · Minimal assistant surgeon | $165.96 | $208.93 | $676.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $208.93 Typical High $676.08 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $208.93 | $676.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $676.08 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $676.08 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | SH · Second concurrent infusion | $602.56 | $602.56 | $602.56 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | SJ · Third+ concurrent infusion | $602.56 | $602.56 | $602.56 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $891.25 Median $954.99 Typical High $2,137.96 | Professional | TC · Technical part | $891.25 | $954.99 | $2,137.96 |
Where North Carolina sits
The same service costs 2.7 times more in Hawaii than in Pennsylvania. 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· 18th of 51
$1,622
HI $3,020PA $1,122
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.