How much rates vary
Facilitymedian $1,778 · 10th to 90th $794 to $1,820Professionalmedian $1,862 · 10th to 90th $1,202 to $2,042
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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,819.70 Typical High $1,819.70 | Professional | None (both parts) | $1,230.27 | $1,819.70 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Facility | None | $2,041.74 | $2,041.74 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,862.09 Typical High $2,511.89 | Professional | None (both parts) | $1,412.54 | $1,862.09 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,778.28 Typical High $1,778.28 | Professional | None (both parts) | $1,318.26 | $1,778.28 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,513.56 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,995.26 | Facility | None | $794.33 | $1,348.96 | $1,995.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,737.80 Typical High $2,951.21 | Professional | None (both parts) | $1,380.38 | $1,737.80 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,445.44 | $1,621.81 |
United Setting Professional Modifier None (both parts) Typical Low $933.25 Median $1,230.27 Typical High $1,862.09 | Professional | None (both parts) | $933.25 | $1,230.27 | $1,862.09 |
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 $645.65 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $645.65 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $128.82 | $181.97 | $181.97 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $691.83 Median $741.31 Typical High $1,659.59 | Professional | 26 · Professional part | $691.83 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,570.40 Typical High $8,317.64 | Professional | 50 · Both sides | $2,089.30 | $2,570.40 | $8,317.64 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $851.14 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $691.83 | $851.14 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $346.74 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $275.42 | $346.74 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $239.88 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $194.98 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $239.88 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $239.88 | $776.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $776.25 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $776.25 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | SH · Second concurrent infusion | $691.83 | $691.83 | $691.83 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | SJ · Third+ concurrent infusion | $691.83 | $691.83 | $691.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,023.29 Median $1,096.48 Typical High $2,454.71 | Professional | TC · Technical part | $1,023.29 | $1,096.48 | $2,454.71 |
Where North Carolina sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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
$1,862
HI $3,715DC $1,318
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.