How much rates vary
Facilitymedian $617 · 10th to 90th $282 to $676Professionalmedian $676 · 10th to 90th $437 to $676
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 $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier None (both parts) Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | None (both parts) | $457.09 | $645.65 | $645.65 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | None (both parts) | $575.44 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None (both parts) Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $446.68 | $616.60 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $588.84 | Professional | None | $446.68 | $478.63 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $478.63 Typical High $724.44 | Facility | None | $281.84 | $478.63 | $724.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $489.78 Median $616.60 Typical High $1,047.13 | Professional | None (both parts) | $489.78 | $616.60 | $1,047.13 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None (both parts) Typical Low $338.84 Median $436.52 Typical High $660.69 | Professional | None (both parts) | $338.84 | $436.52 | $660.69 |
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 $229.09 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $93.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $45.71 | $64.57 | $64.57 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $263.03 Typical High $588.84 | Professional | 26 · Professional part | $245.47 | $263.03 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $2,951.21 | Professional | 50 · Both sides | $741.31 | $912.01 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $309.03 Typical High $977.24 | Professional | 51 · Multiple procedures | $245.47 | $309.03 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $87.10 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $69.18 | $87.10 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $87.10 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $87.10 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $87.10 Typical High $275.42 | Professional | AS · PA/NP assist | $69.18 | $87.10 | $275.42 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | SH · Second concurrent infusion | $245.47 | $245.47 | $245.47 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | SJ · Third+ concurrent infusion | $245.47 | $245.47 | $245.47 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $371.54 Median $398.11 Typical High $891.25 | Professional | TC · Technical part | $371.54 | $398.11 | $891.25 |
Where North Carolina sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 18th of 51
$676
HI $1,660TN $447
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.