How much rates vary
Facilitymedian $1,230 · 10th to 90th $550 to $1,288Professionalmedian $1,318 · 10th to 90th $851 to $1,445
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | None (both parts) | $912.01 | $1,288.25 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,412.54 | $1,412.54 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,318.26 Typical High $1,778.28 | Professional | None (both parts) | $1,000.00 | $1,318.26 | $1,778.28 |
Cigna 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 |
Cigna Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | None (both parts) | $891.25 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,071.52 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $1,412.54 | Facility | None | $549.54 | $933.25 | $1,412.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,202.26 Typical High $2,089.30 | Professional | None (both parts) | $977.24 | $1,202.26 | $2,089.30 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Facility | None | $977.24 | $977.24 | $1,148.15 |
United Setting Professional Modifier None (both parts) Typical Low $660.69 Median $870.96 Typical High $1,288.25 | Professional | None (both parts) | $660.69 | $870.96 | $1,288.25 |
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 $457.09 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $457.09 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $181.97 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $91.20 | $128.82 | $128.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $489.78 Median $524.81 Typical High $1,148.15 | Professional | 26 · Professional part | $489.78 | $524.81 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,819.70 Typical High $5,888.44 | Professional | 50 · Both sides | $1,445.44 | $1,819.70 | $5,888.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $602.56 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $489.78 | $602.56 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $776.25 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $169.82 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $134.90 | $169.82 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $169.82 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $169.82 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $549.54 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $549.54 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | SH · Second concurrent infusion | $489.78 | $489.78 | $489.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | SJ · Third+ concurrent infusion | $489.78 | $489.78 | $489.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $724.44 Median $776.25 Typical High $1,737.80 | Professional | TC · Technical part | $724.44 | $776.25 | $1,737.80 |
Where North Carolina sits
The same service costs 2.8 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· 19th of 51
$1,288
HI $2,455PA $891
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.