How much rates vary
Facilitymedian $1,096 · 10th to 90th $479 to $1,230Professionalmedian $1,148 · 10th to 90th $741 to $1,259
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,096.48 Typical High $1,096.48 | Professional | None (both parts) | $831.76 | $1,096.48 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Facility | None | $1,230.27 | $1,230.27 | $1,479.11 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,148.15 Typical High $1,513.56 | Professional | None (both parts) | $870.96 | $1,148.15 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | None (both parts) | $891.25 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,122.02 | Professional | None | $691.83 | $741.31 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $812.83 Typical High $1,230.27 | Facility | None | $478.63 | $812.83 | $1,230.27 |
Medcost Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,047.13 Typical High $1,778.28 | Professional | None (both parts) | $831.76 | $1,047.13 | $1,778.28 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $575.44 Median $741.31 Typical High $1,122.02 | Professional | None (both parts) | $575.44 | $741.31 | $1,122.02 |
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 $446.68 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $89.13 | $109.65 | $109.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $416.87 Median $446.68 Typical High $1,000.00 | Professional | 26 · Professional part | $416.87 | $446.68 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $5,011.87 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $5,011.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $524.81 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $416.87 | $524.81 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $676.08 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $144.54 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $117.49 | $144.54 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $144.54 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $144.54 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $467.74 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $467.74 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | SH · Second concurrent infusion | $416.87 | $416.87 | $416.87 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | SJ · Third+ concurrent infusion | $416.87 | $416.87 | $416.87 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $630.96 Median $676.08 Typical High $1,513.56 | Professional | TC · Technical part | $630.96 | $676.08 | $1,513.56 |
Where North Carolina sits
The same service costs 2.1 times more in Wisconsin 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· 20th of 51
$1,148
WI $1,820FL $871
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.