How much rates vary
Facilitymedian $724 · 10th to 90th $372 to $977Professionalmedian $1,000 · 10th to 90th $617 to $1,000
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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $616.60 | $977.24 | $977.24 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None (both parts) | $1,202.26 | $1,202.26 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Facility | None | $1,071.52 | $1,071.52 | $1,288.25 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None (both parts) | $851.14 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | None (both parts) | $524.81 | $724.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $851.14 | Professional | None | $602.56 | $660.69 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $1,071.52 | Facility | None | $371.54 | $707.95 | $1,071.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $724.44 Median $912.01 Typical High $1,584.89 | Professional | None (both parts) | $724.44 | $912.01 | $1,584.89 |
United Setting Professional Modifier None (both parts) Typical Low $501.19 Median $645.65 Typical High $891.25 | Professional | None (both parts) | $501.19 | $645.65 | $891.25 |
12 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 55 · Aftercare only Typical Low $95.50 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $95.50 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $97.72 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $363.08 Median $389.05 Typical High $870.96 | Professional | 26 · Professional part | $363.08 | $389.05 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $4,466.84 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $4,466.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $457.09 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $363.08 | $457.09 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $588.84 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $128.82 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $102.33 | $128.82 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $128.82 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $128.82 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $416.87 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $416.87 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | SH · Second concurrent infusion | $363.08 | $363.08 | $363.08 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | SJ · Third+ concurrent infusion | $363.08 | $363.08 | $363.08 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $549.54 Median $588.84 Typical High $1,318.26 | Professional | TC · Technical part | $549.54 | $588.84 | $1,318.26 |
Where North Carolina sits
The same service costs 2.4 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· 18th of 51
$1,000
HI $1,349DE $562
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.