How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,000 to $2,455Professionalmedian $2,399 · 10th to 90th $1,549 to $2,630
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,290.87 Typical High $2,290.87 | Professional | None (both parts) | $1,621.81 | $2,290.87 | $2,290.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,090.30 | Facility | None | $2,570.40 | $2,570.40 | $3,090.30 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,398.83 Typical High $3,162.28 | Professional | None (both parts) | $1,819.70 | $2,398.83 | $3,162.28 |
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 $1,445.44 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,584.89 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $2,570.40 | Facility | None | $1,000.00 | $1,698.24 | $2,570.40 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,187.76 Typical High $3,715.35 | Professional | None (both parts) | $1,737.80 | $2,187.76 | $3,715.35 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,187.76 | Facility | None | $2,089.30 | $2,089.30 | $2,187.76 |
United Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None (both parts) | $1,202.26 | $1,548.82 | $2,344.23 |
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 $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $831.76 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $331.13 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $251.19 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $165.96 | $229.09 | $229.09 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $870.96 Median $933.25 Typical High $2,089.30 | Professional | 26 · Professional part | $870.96 | $933.25 | $2,089.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,235.94 Typical High $10,471.29 | Professional | 50 · Both sides | $2,630.27 | $3,235.94 | $10,471.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,096.48 Typical High $3,548.13 | Professional | 51 · Multiple procedures | $870.96 | $1,096.48 | $3,548.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $302.00 Typical High $977.24 | Professional | 81 · Minimal assistant surgeon | $245.47 | $302.00 | $977.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $302.00 Typical High $977.24 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $302.00 | $977.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $302.00 Typical High $977.24 | Professional | AS · PA/NP assist | $245.47 | $302.00 | $977.24 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | SH · Second concurrent infusion | $870.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | SJ · Third+ concurrent infusion | $870.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,318.26 Median $1,412.54 Typical High $3,162.28 | Professional | TC · Technical part | $1,318.26 | $1,412.54 | $3,162.28 |
Where North Carolina sits
The same service costs 3.4 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· 19th of 51
$2,399
HI $5,623DC $1,660
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.