How much rates vary
Facilitymedian $447 · 10th to 90th $186 to $501Professionalmedian $457 · 10th to 90th $302 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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None (both parts) Typical Low $288.40 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $288.40 | $446.68 | $446.68 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $446.68 Median $457.09 Typical High $616.60 | Professional | None (both parts) | $446.68 | $457.09 | $616.60 |
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 $371.54 Median $501.19 Typical High $501.19 | Professional | None (both parts) | $371.54 | $501.19 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $389.05 | Professional | None | $281.84 | $302.00 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $489.78 | Facility | None | $186.21 | $331.13 | $489.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $338.84 Median $426.58 Typical High $724.44 | Professional | None (both parts) | $338.84 | $426.58 | $724.44 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None (both parts) Typical Low $229.09 Median $302.00 Typical High $436.52 | Professional | None (both parts) | $229.09 | $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 $154.88 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $61.66 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $45.71 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $44.67 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $169.82 Median $181.97 Typical High $407.38 | Professional | 26 · Professional part | $169.82 | $181.97 | $407.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $630.96 Typical High $2,041.74 | Professional | 50 · Both sides | $512.86 | $630.96 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $213.80 Typical High $676.08 | Professional | 51 · Multiple procedures | $169.82 | $213.80 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $85.11 Typical High $275.42 | Professional | 80 · Assistant surgeon | $67.61 | $85.11 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $58.88 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $47.86 | $58.88 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $58.88 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $58.88 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $58.88 Typical High $190.55 | Professional | AS · PA/NP assist | $47.86 | $58.88 | $190.55 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | SH · Second concurrent infusion | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | SJ · Third+ concurrent infusion | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $257.04 Median $275.42 Typical High $602.56 | Professional | TC · Technical part | $257.04 | $275.42 | $602.56 |
Where North Carolina sits
The same service costs 3.0 times more in Hawaii 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· 19th of 51
$457
HI $933DC $316
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.