How much rates vary
Facilitymedian $1,288 · 10th to 90th $661 to $1,549Professionalmedian $1,585 · 10th to 90th $977 to $1,738
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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | None (both parts) | $1,122.02 | $1,548.82 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,041.74 | Facility | None | $1,698.24 | $1,698.24 | $2,041.74 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,584.89 Typical High $2,137.96 | Professional | None (both parts) | $1,202.26 | $1,584.89 | $2,137.96 |
Cigna 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 |
Cigna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,288.25 Typical High $1,288.25 | Professional | None (both parts) | $954.99 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,202.26 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $1,122.02 Typical High $1,698.24 | Facility | None | $660.69 | $1,122.02 | $1,698.24 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,445.44 Typical High $2,511.89 | Professional | None (both parts) | $1,174.90 | $1,445.44 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Facility | None | $1,348.96 | $1,348.96 | $1,380.38 |
United Setting Professional Modifier None (both parts) Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Professional | None (both parts) | $794.33 | $1,023.29 | $1,548.82 |
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 $575.44 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $154.88 | $154.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $575.44 Median $616.60 Typical High $1,380.38 | Professional | 26 · Professional part | $575.44 | $616.60 | $1,380.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,187.76 Typical High $7,079.46 | Professional | 50 · Both sides | $1,737.80 | $2,187.76 | $7,079.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $724.44 Typical High $2,344.23 | Professional | 51 · Multiple procedures | $588.84 | $724.44 | $2,344.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $288.40 Typical High $933.25 | Professional | 80 · Assistant surgeon | $234.42 | $288.40 | $933.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $204.17 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $162.18 | $204.17 | $660.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $204.17 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $204.17 | $660.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $660.69 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $660.69 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | SH · Second concurrent infusion | $588.84 | $588.84 | $588.84 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | SJ · Third+ concurrent infusion | $588.84 | $588.84 | $588.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $933.25 Typical High $2,089.30 | Professional | TC · Technical part | $870.96 | $933.25 | $2,089.30 |
Where North Carolina sits
The same service costs 3.4 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· 21st of 51
$1,549
HI $3,236DE $955
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.