How much rates vary
Facilitymedian $389 · 10th to 90th $200 to $575Professionalmedian $589 · 10th to 90th $355 to $589
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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $331.13 Median $575.44 Typical High $575.44 | Professional | None (both parts) | $331.13 | $575.44 | $575.44 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None (both parts) | $645.65 | $645.65 | $645.65 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | None (both parts) | $512.86 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None (both parts) Typical Low $281.84 Median $389.05 Typical High $407.38 | Professional | None (both parts) | $281.84 | $389.05 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $416.87 | Professional | None | $323.59 | $346.74 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $416.87 Typical High $630.96 | Facility | None | $199.53 | $416.87 | $630.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $436.52 Median $537.03 Typical High $933.25 | Professional | None (both parts) | $436.52 | $537.03 | $933.25 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None (both parts) Typical Low $295.12 Median $389.05 Typical High $478.63 | Professional | None (both parts) | $295.12 | $389.05 | $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 $165.96 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $165.96 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $67.61 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $50.12 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.11 | $57.54 | $57.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $218.78 Median $234.42 Typical High $524.81 | Professional | 26 · Professional part | $218.78 | $234.42 | $524.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $812.83 Typical High $2,630.27 | Professional | 50 · Both sides | $645.65 | $812.83 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $269.15 Typical High $870.96 | Professional | 51 · Multiple procedures | $218.78 | $269.15 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $109.65 Typical High $346.74 | Professional | 80 · Assistant surgeon | $87.10 | $109.65 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $75.86 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $60.26 | $75.86 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $75.86 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $75.86 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $75.86 Typical High $245.47 | Professional | AS · PA/NP assist | $60.26 | $75.86 | $245.47 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | SH · Second concurrent infusion | $218.78 | $218.78 | $218.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | SJ · Third+ concurrent infusion | $218.78 | $218.78 | $218.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $323.59 Median $346.74 Typical High $776.25 | Professional | TC · Technical part | $323.59 | $346.74 | $776.25 |
Where North Carolina sits
The same service costs 2.6 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· 13th of 51
$589
HI $724DE $282
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.