How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,122 to $2,692Professionalmedian $2,754 · 10th to 90th $1,738 to $2,754
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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | None (both parts) | $1,905.46 | $2,691.53 | $2,691.53 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None (both parts) | $2,754.23 | $2,754.23 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,344.23 Median $2,754.23 Typical High $2,754.23 | Professional | None (both parts) | $2,344.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $1,584.89 | $2,137.96 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,819.70 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $2,951.21 | Facility | None | $1,122.02 | $1,949.84 | $2,951.21 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,511.89 Typical High $4,365.16 | Professional | None (both parts) | $2,041.74 | $2,511.89 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,778.28 Typical High $2,570.40 | Professional | None (both parts) | $1,380.38 | $1,778.28 | $2,570.40 |
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 $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,000.00 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $398.11 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $302.00 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $199.53 | $269.15 | $269.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,000.00 Median $1,071.52 Typical High $2,398.83 | Professional | 26 · Professional part | $1,000.00 | $1,071.52 | $2,398.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,801.89 Typical High $12,302.69 | Professional | 50 · Both sides | $3,019.95 | $3,801.89 | $12,302.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,258.93 Typical High $4,073.80 | Professional | 51 · Multiple procedures | $1,000.00 | $1,258.93 | $4,073.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $501.19 Typical High $1,621.81 | Professional | 80 · Assistant surgeon | $407.38 | $501.19 | $1,621.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $354.81 Typical High $1,148.15 | Professional | 81 · Minimal assistant surgeon | $281.84 | $354.81 | $1,148.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $354.81 Typical High $1,148.15 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $354.81 | $1,148.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $354.81 Typical High $1,148.15 | Professional | AS · PA/NP assist | $281.84 | $354.81 | $1,148.15 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | SH · Second concurrent infusion | $1,000.00 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | SJ · Third+ concurrent infusion | $1,000.00 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,513.56 Median $1,621.81 Typical High $3,630.78 | Professional | TC · Technical part | $1,513.56 | $1,621.81 | $3,630.78 |
Where North Carolina sits
The same service costs 2.6 times more in Wisconsin 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· 20th of 51
$2,754
WI $4,074DE $1,585
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.