How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,549 to $4,169Professionalmedian $3,890 · 10th to 90th $2,399 to $4,266
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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,691.53 Median $3,801.89 Typical High $3,801.89 | Professional | None (both parts) | $2,691.53 | $3,801.89 | $3,801.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,011.87 | Facility | None | $4,168.69 | $4,168.69 | $5,011.87 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,951.21 Median $3,890.45 Typical High $5,248.07 | Professional | None (both parts) | $2,951.21 | $3,890.45 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $3,548.13 Typical High $3,548.13 | Professional | None (both parts) | $2,630.27 | $3,548.13 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,398.83 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,548.82 | $2,754.23 | $4,168.69 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $3,548.13 Typical High $6,165.95 | Professional | None (both parts) | $2,884.03 | $3,548.13 | $6,165.95 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
United Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $2,570.40 Typical High $3,630.78 | Professional | None (both parts) | $1,949.84 | $2,570.40 | $3,630.78 |
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 $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,348.96 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $537.03 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $398.11 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $269.15 | $380.19 | $380.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,445.44 Median $1,548.82 Typical High $3,388.44 | Professional | 26 · Professional part | $1,445.44 | $1,548.82 | $3,388.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,265.80 Median $5,370.32 Typical High $17,378.01 | Professional | 50 · Both sides | $4,265.80 | $5,370.32 | $17,378.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,778.28 Typical High $5,754.40 | Professional | 51 · Multiple procedures | $1,445.44 | $1,778.28 | $5,754.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $707.95 Typical High $2,290.87 | Professional | 80 · Assistant surgeon | $575.44 | $707.95 | $2,290.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $501.19 Typical High $1,621.81 | Professional | 81 · Minimal assistant surgeon | $398.11 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $501.19 Typical High $1,621.81 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $501.19 Typical High $1,621.81 | Professional | AS · PA/NP assist | $398.11 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | SH · Second concurrent infusion | $1,445.44 | $1,445.44 | $1,445.44 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | SJ · Third+ concurrent infusion | $1,445.44 | $1,445.44 | $1,445.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,137.96 Median $2,290.87 Typical High $5,128.61 | Professional | TC · Technical part | $2,137.96 | $2,290.87 | $5,128.61 |
Where North Carolina sits
The same service costs 4.3 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· 18th of 51
$3,802
HI $11,220PA $2,630
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.