How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,047 to $2,692Professionalmedian $2,512 · 10th to 90th $1,622 to $2,754
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,454.71 Typical High $2,454.71 | Professional | None (both parts) | $1,737.80 | $2,454.71 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,511.89 Typical High $3,311.31 | Professional | None (both parts) | $1,905.46 | $2,511.89 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $2,691.53 Typical High $2,691.53 | Professional | None (both parts) | $1,949.84 | $2,691.53 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,778.28 | $1,905.46 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,691.53 | Facility | None | $1,047.13 | $1,778.28 | $2,691.53 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,290.87 Typical High $3,890.45 | Professional | None (both parts) | $1,862.09 | $2,290.87 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,862.09 | $1,862.09 | $2,187.76 |
United Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $1,621.81 Typical High $2,454.71 | Professional | None (both parts) | $1,258.93 | $1,621.81 | $2,454.71 |
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 $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $870.96 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $346.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $173.78 | $245.47 | $245.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $912.01 Median $977.24 Typical High $2,187.76 | Professional | 26 · Professional part | $912.01 | $977.24 | $2,187.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,467.37 Typical High $10,964.78 | Professional | 50 · Both sides | $2,754.23 | $3,467.37 | $10,964.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,148.15 Typical High $3,715.35 | Professional | 51 · Multiple procedures | $912.01 | $1,148.15 | $3,715.35 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $457.09 Typical High $1,479.11 | Professional | 80 · Assistant surgeon | $371.54 | $457.09 | $1,479.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $323.59 Typical High $1,023.29 | Professional | 81 · Minimal assistant surgeon | $257.04 | $323.59 | $1,023.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $323.59 Typical High $1,023.29 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $323.59 | $1,023.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $323.59 Typical High $1,023.29 | Professional | AS · PA/NP assist | $257.04 | $323.59 | $1,023.29 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | SH · Second concurrent infusion | $912.01 | $912.01 | $912.01 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | SJ · Third+ concurrent infusion | $912.01 | $912.01 | $912.01 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,380.38 Median $1,479.11 Typical High $3,311.31 | Professional | TC · Technical part | $1,380.38 | $1,479.11 | $3,311.31 |
Where North Carolina sits
The same service costs 2.9 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· 22nd of 51
$2,512
HI $5,012DC $1,738
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.