How much rates vary
Facilitymedian $1,072 · 10th to 90th $468 to $1,202Professionalmedian $1,096 · 10th to 90th $724 to $1,202
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier None (both parts) Typical Low $707.95 Median $1,071.52 Typical High $1,071.52 | Professional | None (both parts) | $707.95 | $1,071.52 | $1,071.52 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None (both parts) | $1,096.48 | $1,318.26 | $1,318.26 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | None (both parts) | $1,071.52 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | None (both parts) | $870.96 | $1,202.26 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | None | $891.25 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,174.90 | Facility | None | $467.74 | $794.33 | $1,174.90 |
Medcost Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,023.29 Typical High $1,737.80 | Professional | None (both parts) | $812.83 | $1,023.29 | $1,737.80 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Facility | None | $457.09 | $457.09 | $724.44 |
United Setting Professional Modifier None (both parts) Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | None (both parts) | $549.54 | $724.44 | $1,071.52 |
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 $380.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $107.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $407.38 Median $436.52 Typical High $977.24 | Professional | 26 · Professional part | $407.38 | $436.52 | $977.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $4,897.79 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $4,897.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $501.19 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $407.38 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $645.65 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $141.25 Typical High $457.09 | Professional | AS · PA/NP assist | $112.20 | $141.25 | $457.09 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | SH · Second concurrent infusion | $407.38 | $407.38 | $407.38 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | SJ · Third+ concurrent infusion | $407.38 | $407.38 | $407.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $602.56 Median $645.65 Typical High $1,445.44 | Professional | TC · Technical part | $602.56 | $645.65 | $1,445.44 |
Where North Carolina sits
The same service costs 2.6 times more in Montana 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· 23rd of 51
$1,096
MT $1,950FL $759
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.