How much rates vary
Facilitymedian $589 · 10th to 90th $257 to $589Professionalmedian $603 · 10th to 90th $389 to $661
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 $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $389.05 Median $588.84 Typical High $588.84 | Professional | None (both parts) | $389.05 | $588.84 | $588.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $776.25 | Facility | None | $645.65 | $645.65 | $776.25 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $457.09 Median $602.56 Typical High $812.83 | Professional | None (both parts) | $457.09 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | None (both parts) | $426.58 | $588.84 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $524.81 | Professional | None | $436.52 | $467.74 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $426.58 Typical High $645.65 | Facility | None | $257.04 | $426.58 | $645.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $446.68 Median $549.54 Typical High $954.99 | Professional | None (both parts) | $446.68 | $549.54 | $954.99 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
United Setting Professional Modifier None (both parts) Typical Low $302.00 Median $398.11 Typical High $588.84 | Professional | None (both parts) | $302.00 | $398.11 | $588.84 |
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 $208.93 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $83.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $41.69 | $58.88 | $58.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $223.87 Median $239.88 Typical High $537.03 | Professional | 26 · Professional part | $223.87 | $239.88 | $537.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $831.76 Typical High $2,691.53 | Professional | 50 · Both sides | $660.69 | $831.76 | $2,691.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $275.42 Typical High $891.25 | Professional | 51 · Multiple procedures | $223.87 | $275.42 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $112.20 Typical High $354.81 | Professional | 80 · Assistant surgeon | $89.13 | $112.20 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $77.62 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $61.66 | $77.62 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $77.62 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $77.62 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $77.62 Typical High $251.19 | Professional | AS · PA/NP assist | $61.66 | $77.62 | $251.19 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | SH · Second concurrent infusion | $223.87 | $223.87 | $223.87 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | SJ · Third+ concurrent infusion | $223.87 | $223.87 | $223.87 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $331.13 Median $354.81 Typical High $794.33 | Professional | TC · Technical part | $331.13 | $354.81 | $794.33 |
Where North Carolina sits
The same service costs 2.5 times more in Montana than in Alabama. 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
$589
MT $1,072AL $427
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.