How much rates vary
Facilitymedian $912 · 10th to 90th $417 to $1,288Professionalmedian $1,288 · 10th to 90th $794 to $1,380
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | None (both parts) | $741.31 | $1,288.25 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,412.54 | $1,412.54 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,318.26 Typical High $1,737.80 | Professional | None (both parts) | $1,000.00 | $1,318.26 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Professional Modifier None (both parts) Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | None (both parts) | $660.69 | $912.01 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $870.96 | Professional | None | $794.33 | $851.14 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $1,412.54 | Facility | None | $416.87 | $933.25 | $1,412.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,202.26 Typical High $2,041.74 | Professional | None (both parts) | $954.99 | $1,202.26 | $2,041.74 |
United Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $676.08 | Facility | None | $575.44 | $575.44 | $676.08 |
United Setting Professional Modifier None (both parts) Typical Low $645.65 Median $851.14 Typical High $1,023.29 | Professional | None (both parts) | $645.65 | $851.14 | $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 $371.54 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $371.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $147.91 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $112.20 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $74.13 | $128.82 | $128.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $478.63 Median $512.86 Typical High $1,148.15 | Professional | 26 · Professional part | $478.63 | $512.86 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,819.70 Typical High $5,754.40 | Professional | 50 · Both sides | $1,445.44 | $1,819.70 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $602.56 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $478.63 | $602.56 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $776.25 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $169.82 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $134.90 | $169.82 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $169.82 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $169.82 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $537.03 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $537.03 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | SH · Second concurrent infusion | $478.63 | $478.63 | $478.63 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | SJ · Third+ concurrent infusion | $478.63 | $478.63 | $478.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $724.44 Median $776.25 Typical High $1,737.80 | Professional | TC · Technical part | $724.44 | $776.25 | $1,737.80 |
Where North Carolina sits
The same service costs 2.3 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· 9th of 51
$1,288
HI $1,514DE $661
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.