How much rates vary
Facilitymedian $871 · 10th to 90th $372 to $933Professionalmedian $891 · 10th to 90th $575 to $933
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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | None (both parts) | $645.65 | $870.96 | $870.96 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None (both parts) | $1,071.52 | $1,071.52 | $1,071.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Facility | None | $954.99 | $954.99 | $1,148.15 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | None (both parts) | $758.58 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | None (both parts) | $676.08 | $933.25 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $812.83 | Professional | None | $724.44 | $776.25 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $630.96 Typical High $954.99 | Facility | None | $371.54 | $630.96 | $954.99 |
Medcost Setting Professional Modifier None (both parts) Typical Low $645.65 Median $812.83 Typical High $1,380.38 | Professional | None (both parts) | $645.65 | $812.83 | $1,380.38 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Facility | None | $478.63 | $478.63 | $575.44 |
United Setting Professional Modifier None (both parts) Typical Low $446.68 Median $575.44 Typical High $870.96 | Professional | None (both parts) | $446.68 | $575.44 | $870.96 |
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 $323.59 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $128.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $95.50 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $87.10 | $87.10 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $346.74 Typical High $776.25 | Professional | 26 · Professional part | $323.59 | $346.74 | $776.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $3,890.45 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $407.38 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $323.59 | $407.38 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $162.18 Typical High $524.81 | Professional | 80 · Assistant surgeon | $128.82 | $162.18 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $114.82 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $91.20 | $114.82 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $114.82 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $114.82 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $363.08 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $363.08 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | SH · Second concurrent infusion | $323.59 | $323.59 | $323.59 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | SJ · Third+ concurrent infusion | $323.59 | $323.59 | $323.59 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $489.78 Median $524.81 Typical High $1,174.90 | Professional | TC · Technical part | $489.78 | $524.81 | $1,174.90 |
Where North Carolina sits
The same service costs 2.1 times more in Wisconsin 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· 22nd of 51
$891
WI $1,349DC $646
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.