How much rates vary
Facilitymedian $1,585 · 10th to 90th $692 to $1,622Professionalmedian $1,660 · 10th to 90th $1,072 to $1,820
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | None (both parts) | $1,202.26 | $1,621.81 | $1,621.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Facility | None | $1,778.28 | $1,778.28 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $1,659.59 Typical High $2,238.72 | Professional | None (both parts) | $1,584.89 | $1,659.59 | $2,238.72 |
Cigna 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 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None (both parts) | $1,174.90 | $1,584.89 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,288.25 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,778.28 | Facility | None | $691.83 | $1,174.90 | $1,778.28 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,513.56 Typical High $2,630.27 | Professional | None (both parts) | $1,230.27 | $1,513.56 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,258.93 | $1,258.93 | $1,445.44 |
United Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None (both parts) | $831.76 | $1,071.52 | $1,621.81 |
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 $602.56 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $602.56 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $239.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $120.23 | $162.18 | $162.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $616.60 Median $645.65 Typical High $1,445.44 | Professional | 26 · Professional part | $616.60 | $645.65 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,290.87 Typical High $7,413.10 | Professional | 50 · Both sides | $1,819.70 | $2,290.87 | $7,413.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $758.58 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $616.60 | $758.58 | $2,454.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $302.00 Typical High $977.24 | Professional | 80 · Assistant surgeon | $245.47 | $302.00 | $977.24 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $213.80 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $169.82 | $213.80 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $213.80 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $213.80 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $691.83 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $691.83 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | SH · Second concurrent infusion | $616.60 | $616.60 | $616.60 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | SJ · Third+ concurrent infusion | $616.60 | $616.60 | $616.60 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $912.01 Median $977.24 Typical High $2,187.76 | Professional | TC · Technical part | $912.01 | $977.24 | $2,187.76 |
Where North Carolina sits
The same service costs 2.7 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· 19th of 51
$1,660
HI $3,162DE $1,175
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.