How much rates vary
Facilitymedian $1,023 · 10th to 90th $447 to $1,047Professionalmedian $1,047 · 10th to 90th $692 to $1,148
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | None (both parts) | $741.31 | $1,023.29 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,348.96 | Facility | None | $1,122.02 | $1,122.02 | $1,348.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,047.13 Typical High $1,412.54 | Professional | None (both parts) | $1,000.00 | $1,047.13 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | None (both parts) | $758.58 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $954.99 | Professional | None | $741.31 | $794.33 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $758.58 Typical High $1,122.02 | Facility | None | $446.68 | $758.58 | $1,122.02 |
Medcost Setting Professional Modifier None (both parts) Typical Low $776.25 Median $954.99 Typical High $1,659.59 | Professional | None (both parts) | $776.25 | $954.99 | $1,659.59 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Facility | None | $912.01 | $912.01 | $1,000.00 |
United Setting Professional Modifier None (both parts) Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | None (both parts) | $524.81 | $691.83 | $1,023.29 |
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 $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $151.36 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $75.86 | $102.33 | $102.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $389.05 Median $416.87 Typical High $933.25 | Professional | 26 · Professional part | $389.05 | $416.87 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,445.44 Typical High $4,677.35 | Professional | 50 · Both sides | $1,148.15 | $1,445.44 | $4,677.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $478.63 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $389.05 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $616.60 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $134.90 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $107.15 | $134.90 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $134.90 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $134.90 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $134.90 Typical High $436.52 | Professional | AS · PA/NP assist | $107.15 | $134.90 | $436.52 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | SH · Second concurrent infusion | $389.05 | $389.05 | $389.05 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | SJ · Third+ concurrent infusion | $389.05 | $389.05 | $389.05 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $575.44 Median $616.60 Typical High $1,380.38 | Professional | TC · Technical part | $575.44 | $616.60 | $1,380.38 |
Where North Carolina sits
The same service costs 3.1 times more in Hawaii than in Pennsylvania. 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
$1,047
HI $2,344PA $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.