How much rates vary
Facilitymedian $1,259 · 10th to 90th $661 to $1,585Professionalmedian $1,549 · 10th to 90th $955 to $1,698
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,513.56 Typical High $1,513.56 | Professional | None (both parts) | $1,148.15 | $1,513.56 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Facility | None | $1,698.24 | $1,698.24 | $1,995.26 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,548.82 Typical High $2,089.30 | Professional | None (both parts) | $1,174.90 | $1,548.82 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None (both parts) | $933.25 | $1,258.93 | $1,258.93 |
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 $1,659.59 | Facility | None | $660.69 | $1,122.02 | $1,659.59 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,412.54 Typical High $2,454.71 | Professional | None (both parts) | $1,148.15 | $1,412.54 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Facility | None | $1,348.96 | $1,348.96 | $1,584.89 |
United Setting Professional Modifier None (both parts) Typical Low $776.25 Median $1,023.29 Typical High $1,513.56 | Professional | None (both parts) | $776.25 | $1,023.29 | $1,513.56 |
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 $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $562.34 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $151.36 | $151.36 |
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 $1,698.24 Median $2,137.96 Typical High $6,918.31 | Professional | 50 · Both sides | $1,698.24 | $2,137.96 | $6,918.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $707.95 Typical High $2,290.87 | Professional | 51 · Multiple procedures | $575.44 | $707.95 | $2,290.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $288.40 Typical High $912.01 | Professional | 80 · Assistant surgeon | $229.09 | $288.40 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $199.53 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $158.49 | $199.53 | $645.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $199.53 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $199.53 | $645.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $199.53 Typical High $645.65 | Professional | AS · PA/NP assist | $158.49 | $199.53 | $645.65 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | SH · Second concurrent infusion | $575.44 | $575.44 | $575.44 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | SJ · Third+ concurrent infusion | $575.44 | $575.44 | $575.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $851.14 Median $912.01 Typical High $2,041.74 | Professional | TC · Technical part | $851.14 | $912.01 | $2,041.74 |
Where North Carolina sits
The same service costs 3.8 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· 20th of 51
$1,514
HI $3,548DE $933
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.