How much rates vary
Facilitymedian $1,380 · 10th to 90th $589 to $1,413Professionalmedian $1,413 · 10th to 90th $912 to $1,549
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | None (both parts) | $977.24 | $1,380.38 | $1,380.38 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,412.54 Typical High $1,862.09 | Professional | None (both parts) | $1,071.52 | $1,412.54 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | None (both parts) | $1,023.29 | $1,412.54 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,096.48 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,513.56 | Facility | None | $588.84 | $1,000.00 | $1,513.56 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,288.25 Typical High $2,187.76 | Professional | None (both parts) | $1,023.29 | $1,288.25 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,230.27 | $1,318.26 |
United Setting Professional Modifier None (both parts) Typical Low $707.95 Median $912.01 Typical High $1,380.38 | Professional | None (both parts) | $707.95 | $912.01 | $1,380.38 |
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 $489.78 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $147.91 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $138.04 | $138.04 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $512.86 Median $549.54 Typical High $1,230.27 | Professional | 26 · Professional part | $512.86 | $549.54 | $1,230.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,949.84 Typical High $6,165.95 | Professional | 50 · Both sides | $1,548.82 | $1,949.84 | $6,165.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $645.65 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $512.86 | $645.65 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $831.76 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $181.97 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $144.54 | $181.97 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $181.97 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $181.97 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $575.44 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $575.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | SH · Second concurrent infusion | $512.86 | $512.86 | $512.86 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | SJ · Third+ concurrent infusion | $512.86 | $512.86 | $512.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $831.76 Typical High $1,862.09 | Professional | TC · Technical part | $776.25 | $831.76 | $1,862.09 |
Where North Carolina sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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· 20th of 51
$1,413
HI $3,548DC $977
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.