How much rates vary
Facilitymedian $398 · 10th to 90th $204 to $479Professionalmedian $490 · 10th to 90th $302 to $490
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None (both parts) Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | None (both parts) | $316.23 | $478.63 | $478.63 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $489.78 | $489.78 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $630.96 | Facility | None | $537.03 | $537.03 | $630.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $426.58 | $489.78 | $489.78 |
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 $288.40 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $288.40 | $398.11 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $467.74 | Professional | None | $302.00 | $323.59 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $354.81 Typical High $524.81 | Facility | None | $204.17 | $354.81 | $524.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $363.08 Median $457.09 Typical High $776.25 | Professional | None (both parts) | $363.08 | $457.09 | $776.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None (both parts) Typical Low $245.47 Median $323.59 Typical High $478.63 | Professional | None (both parts) | $245.47 | $323.59 | $478.63 |
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 $186.21 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $74.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $54.95 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $47.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $194.98 Typical High $436.52 | Professional | 26 · Professional part | $181.97 | $194.98 | $436.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $676.08 Typical High $2,187.76 | Professional | 50 · Both sides | $537.03 | $676.08 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $223.87 Typical High $724.44 | Professional | 51 · Multiple procedures | $181.97 | $223.87 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $91.20 Typical High $288.40 | Professional | 80 · Assistant surgeon | $72.44 | $91.20 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $63.10 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $50.12 | $63.10 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $63.10 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $63.10 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $63.10 Typical High $204.17 | Professional | AS · PA/NP assist | $50.12 | $63.10 | $204.17 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | SH · Second concurrent infusion | $181.97 | $181.97 | $181.97 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | SJ · Third+ concurrent infusion | $181.97 | $181.97 | $181.97 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $269.15 Median $288.40 Typical High $645.65 | Professional | TC · Technical part | $269.15 | $288.40 | $645.65 |
Where North Carolina sits
The same service costs 2.8 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· 19th of 51
$490
HI $794DE $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.