How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,318 to $3,388Professionalmedian $3,236 · 10th to 90th $2,042 to $3,548
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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $3,162.28 Typical High $3,162.28 | Professional | None (both parts) | $2,137.96 | $3,162.28 | $3,162.28 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,235.94 Typical High $4,265.80 | Professional | None (both parts) | $2,454.71 | $3,235.94 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,388.44 Typical High $3,388.44 | Professional | None (both parts) | $2,454.71 | $3,388.44 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,089.30 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $3,467.37 | Facility | None | $1,318.26 | $2,290.87 | $3,467.37 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,344.23 Median $2,951.21 Typical High $5,011.87 | Professional | None (both parts) | $2,344.23 | $2,951.21 | $5,011.87 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,089.30 Typical High $3,090.30 | Professional | None (both parts) | $1,621.81 | $2,089.30 | $3,090.30 |
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 $1,148.15 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,148.15 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $457.09 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $346.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $229.09 | $316.23 | $316.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,174.90 Median $1,258.93 Typical High $2,818.38 | Professional | 26 · Professional part | $1,174.90 | $1,258.93 | $2,818.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,548.13 Median $4,466.84 Typical High $14,125.38 | Professional | 50 · Both sides | $3,548.13 | $4,466.84 | $14,125.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,174.90 Median $1,479.11 Typical High $4,786.30 | Professional | 51 · Multiple procedures | $1,174.90 | $1,479.11 | $4,786.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $588.84 Typical High $1,905.46 | Professional | 80 · Assistant surgeon | $478.63 | $588.84 | $1,905.46 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $416.87 Typical High $1,318.26 | Professional | 81 · Minimal assistant surgeon | $331.13 | $416.87 | $1,318.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $416.87 Typical High $1,318.26 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $416.87 | $1,318.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $416.87 Typical High $1,318.26 | Professional | AS · PA/NP assist | $331.13 | $416.87 | $1,318.26 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | SH · Second concurrent infusion | $1,174.90 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | SJ · Third+ concurrent infusion | $1,174.90 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,778.28 Median $1,905.46 Typical High $4,265.80 | Professional | TC · Technical part | $1,778.28 | $1,905.46 | $4,265.80 |
Where North Carolina sits
The same service costs 2.1 times more in Montana than in South Carolina. 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
$3,236
MT $4,898SC $2,344
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.