How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $1,862Professionalmedian $1,905 · 10th to 90th $1,175 to $2,089
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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,862.09 Typical High $1,862.09 | Professional | None (both parts) | $1,318.26 | $1,862.09 | $1,862.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Facility | None | $2,041.74 | $2,041.74 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $1,905.46 Typical High $2,511.89 | Professional | None (both parts) | $1,445.44 | $1,905.46 | $2,511.89 |
Cigna 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 |
Cigna 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 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,445.44 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,348.96 Typical High $2,041.74 | Facility | None | $794.33 | $1,348.96 | $2,041.74 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,737.80 Typical High $2,951.21 | Professional | None (both parts) | $1,412.54 | $1,737.80 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,698.24 | Facility | None | $1,479.11 | $1,479.11 | $1,698.24 |
United Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,230.27 Typical High $1,862.09 | Professional | None (both parts) | $954.99 | $1,230.27 | $1,862.09 |
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 $660.69 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $660.69 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $263.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $199.53 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $131.83 | $186.21 | $186.21 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $691.83 Median $741.31 Typical High $1,659.59 | Professional | 26 · Professional part | $691.83 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,630.27 Typical High $8,511.38 | Professional | 50 · Both sides | $2,089.30 | $2,630.27 | $8,511.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $870.96 Typical High $2,818.38 | Professional | 51 · Multiple procedures | $691.83 | $870.96 | $2,818.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $346.74 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $281.84 | $346.74 | $1,122.02 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $245.47 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $194.98 | $245.47 | $794.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $245.47 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $245.47 | $794.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $794.33 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $794.33 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | SH · Second concurrent infusion | $691.83 | $691.83 | $691.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | SJ · Third+ concurrent infusion | $691.83 | $691.83 | $691.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,047.13 Median $1,122.02 Typical High $2,511.89 | Professional | TC · Technical part | $1,047.13 | $1,122.02 | $2,511.89 |
Where North Carolina sits
The same service costs 3.0 times more in Iowa 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
$1,862
IA $3,311DE $1,122
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.