How much rates vary
Facilitymedian $871 · 10th to 90th $437 to $1,000Professionalmedian $1,023 · 10th to 90th $631 to $1,122
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | None (both parts) | $676.08 | $1,000.00 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $776.25 Median $1,023.29 Typical High $1,380.38 | Professional | None (both parts) | $776.25 | $1,023.29 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $630.96 Median $870.96 Typical High $870.96 | Professional | None (both parts) | $630.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $912.01 | Professional | None | $630.96 | $676.08 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $741.31 Typical High $1,096.48 | Facility | None | $436.52 | $741.31 | $1,096.48 |
Medcost Setting Professional Modifier None (both parts) Typical Low $758.58 Median $954.99 Typical High $1,621.81 | Professional | None (both parts) | $758.58 | $954.99 | $1,621.81 |
United Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Facility | None | $891.25 | $891.25 | $1,513.56 |
United Setting Professional Modifier None (both parts) Typical Low $512.86 Median $676.08 Typical High $1,000.00 | Professional | None (both parts) | $512.86 | $676.08 | $1,000.00 |
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 $338.84 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $100.00 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $67.61 | $100.00 | $100.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $380.19 Median $407.38 Typical High $912.01 | Professional | 26 · Professional part | $380.19 | $407.38 | $912.01 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,412.54 Typical High $4,570.88 | Professional | 50 · Both sides | $1,148.15 | $1,412.54 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $467.74 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $380.19 | $467.74 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $602.56 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $131.83 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $107.15 | $131.83 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $131.83 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $131.83 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $426.58 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $426.58 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | SH · Second concurrent infusion | $380.19 | $380.19 | $380.19 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | SJ · Third+ concurrent infusion | $380.19 | $380.19 | $380.19 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $562.34 Median $602.56 Typical High $1,348.96 | Professional | TC · Technical part | $562.34 | $602.56 | $1,348.96 |
Where North Carolina sits
The same service costs 4.0 times more in Hawaii 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
$1,000
HI $2,512DE $631
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.