How much rates vary
Facilitymedian $1,820 · 10th to 90th $741 to $2,138Professionalmedian $2,188 · 10th to 90th $1,318 to $2,399
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $1,288.25 | $2,137.96 | $2,137.96 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $2,187.76 Typical High $3,090.30 | Professional | None (both parts) | $2,187.76 | $2,187.76 | $3,090.30 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,818.38 | Facility | None | $2,344.23 | $2,344.23 | $2,818.38 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,187.76 Typical High $2,951.21 | Professional | None (both parts) | $1,659.59 | $2,187.76 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,819.70 Typical High $1,819.70 | Professional | None (both parts) | $1,318.26 | $1,819.70 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,445.44 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,548.82 Typical High $2,344.23 | Facility | None | $741.31 | $1,548.82 | $2,344.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $1,995.26 Typical High $3,467.37 | Professional | None (both parts) | $1,621.81 | $1,995.26 | $3,467.37 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Facility | None | $870.96 | $870.96 | $1,148.15 |
United Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,412.54 Typical High $1,778.28 | Professional | None (both parts) | $1,096.48 | $1,412.54 | $1,778.28 |
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 $645.65 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $645.65 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $257.04 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $190.55 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $128.82 | $213.80 | $213.80 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $812.83 Median $851.14 Typical High $1,905.46 | Professional | 26 · Professional part | $812.83 | $851.14 | $1,905.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,019.95 Typical High $9,772.37 | Professional | 50 · Both sides | $2,398.83 | $3,019.95 | $9,772.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $1,000.00 Typical High $3,235.94 | Professional | 51 · Multiple procedures | $812.83 | $1,000.00 | $3,235.94 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $1,288.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $281.84 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $223.87 | $281.84 | $912.01 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $281.84 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $281.84 | $912.01 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $281.84 Typical High $912.01 | Professional | AS · PA/NP assist | $223.87 | $281.84 | $912.01 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | SH · Second concurrent infusion | $812.83 | $812.83 | $812.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | SJ · Third+ concurrent infusion | $812.83 | $812.83 | $812.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,202.26 Median $1,288.25 Typical High $2,884.03 | Professional | TC · Technical part | $1,202.26 | $1,288.25 | $2,884.03 |
Where North Carolina sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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· 16th of 51
$2,138
WI $2,951PA $1,288
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.