How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,000 to $2,570Professionalmedian $2,692 · 10th to 90th $1,660 to $2,951
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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | None (both parts) | $1,621.81 | $2,570.40 | $2,570.40 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,467.37 | Facility | None | $2,884.03 | $2,884.03 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,691.53 Typical High $3,548.13 | Professional | None (both parts) | $2,041.74 | $2,691.53 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,570.40 Typical High $2,570.40 | Professional | None (both parts) | $1,862.09 | $2,570.40 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,698.24 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $2,884.03 | Facility | None | $1,000.00 | $1,905.46 | $2,884.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $2,454.71 Typical High $4,168.69 | Professional | None (both parts) | $1,949.84 | $2,454.71 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Facility | None | $1,288.25 | $1,288.25 | $1,659.59 |
United Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,737.80 Typical High $2,344.23 | Professional | None (both parts) | $1,318.26 | $1,737.80 | $2,344.23 |
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 $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $812.83 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $323.59 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $245.47 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $162.18 | $257.04 | $257.04 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $977.24 Median $1,047.13 Typical High $2,344.23 | Professional | 26 · Professional part | $977.24 | $1,047.13 | $2,344.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,630.78 Typical High $11,748.98 | Professional | 50 · Both sides | $2,951.21 | $3,630.78 | $11,748.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,230.27 Typical High $3,890.45 | Professional | 51 · Multiple procedures | $977.24 | $1,230.27 | $3,890.45 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $489.78 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $389.05 | $489.78 | $1,584.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $338.84 Typical High $1,096.48 | Professional | 81 · Minimal assistant surgeon | $275.42 | $338.84 | $1,096.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $338.84 Typical High $1,096.48 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $338.84 | $1,096.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $338.84 Typical High $1,096.48 | Professional | AS · PA/NP assist | $275.42 | $338.84 | $1,096.48 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | SH · Second concurrent infusion | $977.24 | $977.24 | $977.24 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | SJ · Third+ concurrent infusion | $977.24 | $977.24 | $977.24 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,479.11 Median $1,584.89 Typical High $3,548.13 | Professional | TC · Technical part | $1,479.11 | $1,584.89 | $3,548.13 |
Where North Carolina sits
The same service costs 2.4 times more in Wisconsin than in Washington, DC. 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· 17th of 51
$2,630
WI $3,981DC $1,660
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.