How much rates vary
Facilitymedian $427 · 10th to 90th $219 to $513Professionalmedian $525 · 10th to 90th $324 to $575
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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $512.86 Typical High $512.86 | Professional | None (both parts) | $363.08 | $512.86 | $512.86 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | None (both parts) | $588.84 | $630.96 | $630.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Facility | None | $562.34 | $562.34 | $676.08 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $398.11 Median $524.81 Typical High $691.83 | Professional | None (both parts) | $398.11 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | None (both parts) | $309.03 | $426.58 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | None | $371.54 | $407.38 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $562.34 | Facility | None | $218.78 | $371.54 | $562.34 |
Medcost Setting Professional Modifier None (both parts) Typical Low $380.19 Median $478.63 Typical High $812.83 | Professional | None (both parts) | $380.19 | $478.63 | $812.83 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $457.09 | Facility | None | $426.58 | $426.58 | $457.09 |
United Setting Professional Modifier None (both parts) Typical Low $263.03 Median $338.84 Typical High $512.86 | Professional | None (both parts) | $263.03 | $338.84 | $512.86 |
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 $181.97 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $181.97 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $74.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $204.17 Typical High $457.09 | Professional | 26 · Professional part | $190.55 | $204.17 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $724.44 Typical High $2,290.87 | Professional | 50 · Both sides | $575.44 | $724.44 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $239.88 Typical High $776.25 | Professional | 51 · Multiple procedures | $190.55 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $95.50 Typical High $309.03 | Professional | 80 · Assistant surgeon | $77.62 | $95.50 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $67.61 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $53.70 | $67.61 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $67.61 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $67.61 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $67.61 Typical High $213.80 | Professional | AS · PA/NP assist | $53.70 | $67.61 | $213.80 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | SH · Second concurrent infusion | $190.55 | $190.55 | $190.55 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | SJ · Third+ concurrent infusion | $190.55 | $190.55 | $190.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $288.40 Median $309.03 Typical High $691.83 | Professional | TC · Technical part | $288.40 | $309.03 | $691.83 |
Where North Carolina sits
The same service costs 3.8 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· 20th of 51
$513
HI $1,175DE $309
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.