How much rates vary
Facilitymedian $457 · 10th to 90th $186 to $501Professionalmedian $468 · 10th to 90th $288 to $513
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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $457.09 | Professional | None (both parts) | $316.23 | $457.09 | $457.09 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $354.81 Median $467.74 Typical High $630.96 | Professional | None (both parts) | $354.81 | $467.74 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | None (both parts) | $363.08 | $501.19 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $436.52 | Professional | None | $323.59 | $346.74 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $501.19 | Facility | None | $186.21 | $331.13 | $501.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $346.74 Median $426.58 Typical High $741.31 | Professional | None (both parts) | $346.74 | $426.58 | $741.31 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Facility | None | $229.09 | $229.09 | $288.40 |
United Setting Professional Modifier None (both parts) Typical Low $234.42 Median $302.00 Typical High $436.52 | Professional | None (both parts) | $234.42 | $302.00 | $436.52 |
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 $169.82 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $51.29 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $45.71 | $45.71 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $173.78 Median $181.97 Typical High $407.38 | Professional | 26 · Professional part | $173.78 | $181.97 | $407.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $645.65 Typical High $2,089.30 | Professional | 50 · Both sides | $512.86 | $645.65 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $213.80 Typical High $691.83 | Professional | 51 · Multiple procedures | $173.78 | $213.80 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $85.11 Typical High $275.42 | Professional | 80 · Assistant surgeon | $69.18 | $85.11 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $60.26 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $47.86 | $60.26 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $60.26 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $60.26 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $60.26 Typical High $194.98 | Professional | AS · PA/NP assist | $47.86 | $60.26 | $194.98 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SH · Second concurrent infusion | $173.78 | $173.78 | $173.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SJ · Third+ concurrent infusion | $173.78 | $173.78 | $173.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $257.04 Median $275.42 Typical High $616.60 | Professional | TC · Technical part | $257.04 | $275.42 | $616.60 |
Where North Carolina sits
The same service costs 2.3 times more in Wisconsin than in Florida. 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
$468
WI $776FL $339
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.