How much rates vary
Facilitymedian $398 · 10th to 90th $191 to $437Professionalmedian $457 · 10th to 90th $295 to $501
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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $309.03 | $436.52 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Facility | None | $489.78 | $489.78 | $588.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $346.74 Median $457.09 Typical High $602.56 | Professional | None (both parts) | $346.74 | $457.09 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $295.12 | $398.11 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $323.59 Typical High $489.78 | Facility | None | $190.55 | $323.59 | $489.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $331.13 Median $416.87 Typical High $707.95 | Professional | None (both parts) | $331.13 | $416.87 | $707.95 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None (both parts) Typical Low $229.09 Median $295.12 Typical High $446.68 | Professional | None (both parts) | $229.09 | $295.12 | $446.68 |
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 $158.49 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $63.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $31.62 | $43.65 | $43.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $165.96 Median $177.83 Typical High $398.11 | Professional | 26 · Professional part | $165.96 | $177.83 | $398.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $1,995.26 | Professional | 50 · Both sides | $501.19 | $630.96 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $208.93 Typical High $660.69 | Professional | 51 · Multiple procedures | $165.96 | $208.93 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $83.18 Typical High $269.15 | Professional | 80 · Assistant surgeon | $66.07 | $83.18 | $269.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $46.77 Median $58.88 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $46.77 | $58.88 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $46.77 Median $58.88 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $46.77 | $58.88 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $58.88 Typical High $186.21 | Professional | AS · PA/NP assist | $46.77 | $58.88 | $186.21 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | SH · Second concurrent infusion | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | SJ · Third+ concurrent infusion | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $251.19 Median $269.15 Typical High $602.56 | Professional | TC · Technical part | $251.19 | $269.15 | $602.56 |
Where North Carolina sits
The same service costs 3.7 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
$447
HI $1,096DE $295
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.