How much rates vary
Facilitymedian $562 · 10th to 90th $245 to $661Professionalmedian $575 · 10th to 90th $380 to $661
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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None (both parts) Typical Low $380.19 Median $562.34 Typical High $562.34 | Professional | None (both parts) | $380.19 | $562.34 | $562.34 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $380.19 Median $691.83 Typical High $691.83 | Professional | None (both parts) | $380.19 | $691.83 | $691.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Facility | None | $630.96 | $630.96 | $758.58 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $446.68 Median $575.44 Typical High $776.25 | Professional | None (both parts) | $446.68 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None (both parts) Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None (both parts) | $489.78 | $660.69 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $512.86 | Professional | None | $371.54 | $398.11 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $416.87 Typical High $616.60 | Facility | None | $245.47 | $416.87 | $616.60 |
Medcost Setting Professional Modifier None (both parts) Typical Low $426.58 Median $537.03 Typical High $912.01 | Professional | None (both parts) | $426.58 | $537.03 | $912.01 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
United Setting Professional Modifier None (both parts) Typical Low $288.40 Median $380.19 Typical High $575.44 | Professional | None (both parts) | $288.40 | $380.19 | $575.44 |
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 $199.53 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $81.28 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $56.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $229.09 Typical High $512.86 | Professional | 26 · Professional part | $213.80 | $229.09 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $794.33 Typical High $2,570.40 | Professional | 50 · Both sides | $645.65 | $794.33 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $269.15 Typical High $851.14 | Professional | 51 · Multiple procedures | $213.80 | $269.15 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $107.15 Typical High $346.74 | Professional | 80 · Assistant surgeon | $85.11 | $107.15 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $74.13 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $60.26 | $74.13 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $74.13 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $74.13 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $74.13 Typical High $239.88 | Professional | AS · PA/NP assist | $60.26 | $74.13 | $239.88 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | SH · Second concurrent infusion | $213.80 | $213.80 | $213.80 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | SJ · Third+ concurrent infusion | $213.80 | $213.80 | $213.80 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $323.59 Median $346.74 Typical High $758.58 | Professional | TC · Technical part | $323.59 | $346.74 | $758.58 |
Where North Carolina sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 23rd of 51
$575
HI $1,380KS $339
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.