How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $1,175Professionalmedian $1,230 · 10th to 90th $759 to $1,349
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | None (both parts) | $758.58 | $1,174.90 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Facility | None | $1,318.26 | $1,318.26 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,230.27 Typical High $1,621.81 | Professional | None (both parts) | $1,174.90 | $1,230.27 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None (both parts) Typical Low $691.83 Median $954.99 Typical High $954.99 | Professional | None (both parts) | $691.83 | $954.99 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,047.13 | Professional | None | $741.31 | $794.33 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $870.96 Typical High $1,318.26 | Facility | None | $457.09 | $870.96 | $1,318.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,122.02 Typical High $1,905.46 | Professional | None (both parts) | $891.25 | $1,122.02 | $1,905.46 |
United Setting Professional Modifier None (both parts) Typical Low $602.56 Median $794.33 Typical High $1,096.48 | Professional | None (both parts) | $602.56 | $794.33 | $1,096.48 |
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 $389.05 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $389.05 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $154.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $117.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $77.62 | $117.49 | $117.49 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $446.68 Median $478.63 Typical High $1,071.52 | Professional | 26 · Professional part | $446.68 | $478.63 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $5,370.32 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $562.34 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $446.68 | $562.34 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $223.87 Typical High $724.44 | Professional | 80 · Assistant surgeon | $177.83 | $223.87 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $158.49 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $125.89 | $158.49 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $158.49 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $158.49 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $501.19 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $501.19 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | SH · Second concurrent infusion | $446.68 | $446.68 | $446.68 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | SJ · Third+ concurrent infusion | $446.68 | $446.68 | $446.68 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $676.08 Median $724.44 Typical High $1,621.81 | Professional | TC · Technical part | $676.08 | $724.44 | $1,621.81 |
Where North Carolina sits
The same service costs 2.4 times more in Montana 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· 16th of 51
$1,202
MT $1,660DE $692
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.