How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,445 to $3,311Professionalmedian $3,388 · 10th to 90th $2,188 to $3,715
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 $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,238.72 Median $3,311.31 Typical High $3,311.31 | Professional | None (both parts) | $2,238.72 | $3,311.31 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $3,235.94 Median $3,388.44 Typical High $4,570.88 | Professional | None (both parts) | $3,235.94 | $3,388.44 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,754.23 Typical High $2,754.23 | Professional | None (both parts) | $2,041.74 | $2,754.23 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,344.23 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $3,630.78 | Facility | None | $1,445.44 | $2,454.71 | $3,630.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $3,090.30 Typical High $5,370.32 | Professional | None (both parts) | $2,511.89 | $3,090.30 | $5,370.32 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,454.71 | $2,454.71 | $2,511.89 |
United Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,238.72 Typical High $3,311.31 | Professional | None (both parts) | $1,698.24 | $2,238.72 | $3,311.31 |
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 $1,122.02 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,122.02 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $457.09 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $229.09 | $331.13 | $331.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,258.93 Median $1,348.96 Typical High $3,019.95 | Professional | 26 · Professional part | $1,258.93 | $1,348.96 | $3,019.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,677.35 Typical High $15,135.61 | Professional | 50 · Both sides | $3,715.35 | $4,677.35 | $15,135.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,548.82 Typical High $5,011.87 | Professional | 51 · Multiple procedures | $1,258.93 | $1,548.82 | $5,011.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $630.96 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $501.19 | $630.96 | $1,995.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | 81 · Minimal assistant surgeon | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | AS · PA/NP assist | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | SH · Second concurrent infusion | $1,258.93 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | SJ · Third+ concurrent infusion | $1,258.93 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,862.09 Median $1,995.26 Typical High $4,466.84 | Professional | TC · Technical part | $1,862.09 | $1,995.26 | $4,466.84 |
Where North Carolina sits
The same service costs 2.8 times more in Wyoming 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· 16th of 51
$3,388
WY $5,754DE $2,042
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.