How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,023 to $2,455Professionalmedian $2,455 · 10th to 90th $1,585 to $2,692
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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Professional | None (both parts) | $1,862.09 | $2,344.23 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,454.71 Typical High $3,235.94 | Professional | None (both parts) | $1,862.09 | $2,454.71 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,454.71 Typical High $2,454.71 | Professional | None (both parts) | $1,819.70 | $2,454.71 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,698.24 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $2,630.27 | Facility | None | $1,023.29 | $1,737.80 | $2,630.27 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,778.28 Median $2,238.72 Typical High $3,801.89 | Professional | None (both parts) | $1,778.28 | $2,238.72 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,698.24 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,584.89 Typical High $2,398.83 | Professional | None (both parts) | $1,230.27 | $1,584.89 | $2,398.83 |
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 $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $933.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $371.54 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $186.21 | $234.42 | $234.42 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $891.25 Median $954.99 Typical High $2,137.96 | Professional | 26 · Professional part | $891.25 | $954.99 | $2,137.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $3,311.31 Typical High $10,715.19 | Professional | 50 · Both sides | $2,691.53 | $3,311.31 | $10,715.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,122.02 Typical High $3,548.13 | Professional | 51 · Multiple procedures | $891.25 | $1,122.02 | $3,548.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $446.68 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $354.81 | $446.68 | $1,445.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $309.03 Typical High $1,000.00 | Professional | 81 · Minimal assistant surgeon | $251.19 | $309.03 | $1,000.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $309.03 Typical High $1,000.00 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $309.03 | $1,000.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $309.03 Typical High $1,000.00 | Professional | AS · PA/NP assist | $251.19 | $309.03 | $1,000.00 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | SH · Second concurrent infusion | $891.25 | $891.25 | $891.25 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | SJ · Third+ concurrent infusion | $891.25 | $891.25 | $891.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,348.96 Median $1,445.44 Typical High $3,235.94 | Professional | TC · Technical part | $1,348.96 | $1,445.44 | $3,235.94 |
Where North Carolina sits
The same service costs 2.4 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· 18th of 51
$2,455
HI $4,365DE $1,820
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.