How much rates vary
Facilitymedian $389 · 10th to 90th $170 to $398Professionalmedian $407 · 10th to 90th $263 to $447
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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $389.05 Typical High $389.05 | Professional | None (both parts) | $275.42 | $389.05 | $389.05 |
BCBS North Carolina Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $524.81 | Facility | None | $436.52 | $436.52 | $524.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $309.03 Median $407.38 Typical High $537.03 | Professional | None (both parts) | $309.03 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $295.12 | $398.11 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $354.81 | Professional | None | $281.84 | $302.00 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $436.52 | Facility | None | $169.82 | $288.40 | $436.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $295.12 Median $371.54 Typical High $630.96 | Professional | None (both parts) | $295.12 | $371.54 | $630.96 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $331.13 | Facility | None | $257.04 | $257.04 | $331.13 |
United Setting Professional Modifier None (both parts) Typical Low $204.17 Median $263.03 Typical High $398.11 | Professional | None (both parts) | $204.17 | $263.03 | $398.11 |
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 $141.25 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.18 | $38.90 | $38.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $147.91 Median $158.49 Typical High $354.81 | Professional | 26 · Professional part | $147.91 | $158.49 | $354.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $562.34 Typical High $1,778.28 | Professional | 50 · Both sides | $446.68 | $562.34 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $186.21 Typical High $602.56 | Professional | 51 · Multiple procedures | $147.91 | $186.21 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $74.13 Typical High $239.88 | Professional | 80 · Assistant surgeon | $58.88 | $74.13 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $52.48 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $41.69 | $52.48 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $52.48 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $52.48 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $52.48 Typical High $165.96 | Professional | AS · PA/NP assist | $41.69 | $52.48 | $165.96 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | SH · Second concurrent infusion | $147.91 | $147.91 | $147.91 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | SJ · Third+ concurrent infusion | $147.91 | $147.91 | $147.91 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $223.87 Median $239.88 Typical High $537.03 | Professional | TC · Technical part | $223.87 | $239.88 | $537.03 |
Where North Carolina sits
The same service costs 2.5 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· 21st of 51
$398
HI $708DC $282
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.