How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,380 to $3,631Professionalmedian $3,715 · 10th to 90th $2,291 to $3,715
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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,290.87 Median $3,630.78 Typical High $3,630.78 | Professional | None (both parts) | $2,290.87 | $3,630.78 | $3,630.78 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None (both parts) | $4,466.84 | $4,466.84 | $4,466.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,786.30 | Facility | None | $3,981.07 | $3,981.07 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $3,715.35 Typical High $3,715.35 | Professional | None (both parts) | $3,162.28 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,884.03 Typical High $2,884.03 | Professional | None (both parts) | $2,089.30 | $2,884.03 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,454.71 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,981.07 | Facility | None | $1,380.38 | $2,630.27 | $3,981.07 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,691.53 Median $3,388.44 Typical High $5,888.44 | Professional | None (both parts) | $2,691.53 | $3,388.44 | $5,888.44 |
United Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,398.83 Typical High $3,311.31 | Professional | None (both parts) | $1,862.09 | $2,398.83 | $3,311.31 |
12 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 55 · Aftercare only Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $354.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $234.42 | $363.08 | $363.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,348.96 Median $1,445.44 Typical High $3,235.94 | Professional | 26 · Professional part | $1,348.96 | $1,445.44 | $3,235.94 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $5,128.61 Typical High $16,595.87 | Professional | 50 · Both sides | $4,073.80 | $5,128.61 | $16,595.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,698.24 Typical High $5,495.41 | Professional | 51 · Multiple procedures | $1,348.96 | $1,698.24 | $5,495.41 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $676.08 Typical High $2,187.76 | Professional | 80 · Assistant surgeon | $549.54 | $676.08 | $2,187.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $478.63 Typical High $1,548.82 | Professional | 81 · Minimal assistant surgeon | $380.19 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $478.63 Typical High $1,548.82 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $478.63 Typical High $1,548.82 | Professional | AS · PA/NP assist | $380.19 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | SH · Second concurrent infusion | $1,348.96 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | SJ · Third+ concurrent infusion | $1,348.96 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,041.74 Median $2,187.76 Typical High $4,897.79 | Professional | TC · Technical part | $2,041.74 | $2,187.76 | $4,897.79 |
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
$3,715
MT $5,012DE $2,089
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.