How much rates vary
Facilitymedian $417 · 10th to 90th $204 to $537Professionalmedian $562 · 10th to 90th $331 to $617
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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $323.59 Median $537.03 Typical High $537.03 | Professional | None (both parts) | $323.59 | $537.03 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Facility | None | $602.56 | $602.56 | $724.44 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $426.58 Median $562.34 Typical High $741.31 | Professional | None (both parts) | $426.58 | $562.34 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $302.00 Median $416.87 Typical High $426.58 | Professional | None (both parts) | $302.00 | $416.87 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | None | $398.11 | $426.58 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $398.11 Typical High $602.56 | Facility | None | $204.17 | $398.11 | $602.56 |
Medcost Setting Professional Modifier None (both parts) Typical Low $407.38 Median $512.86 Typical High $870.96 | Professional | None (both parts) | $407.38 | $512.86 | $870.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $467.74 | Facility | None | $426.58 | $426.58 | $467.74 |
United Setting Professional Modifier None (both parts) Typical Low $275.42 Median $363.08 Typical High $489.78 | Professional | None (both parts) | $275.42 | $363.08 | $489.78 |
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 $162.18 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $162.18 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $64.57 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $48.98 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $32.36 | $53.70 | $53.70 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $218.78 Typical High $489.78 | Professional | 26 · Professional part | $204.17 | $218.78 | $489.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $776.25 Typical High $2,454.71 | Professional | 50 · Both sides | $616.60 | $776.25 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $257.04 Typical High $831.76 | Professional | 51 · Multiple procedures | $204.17 | $257.04 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $102.33 Typical High $331.13 | Professional | 80 · Assistant surgeon | $81.28 | $102.33 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $72.44 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $57.54 | $72.44 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $72.44 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $72.44 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $72.44 Typical High $229.09 | Professional | AS · PA/NP assist | $57.54 | $72.44 | $229.09 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | SH · Second concurrent infusion | $204.17 | $204.17 | $204.17 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | SJ · Third+ concurrent infusion | $204.17 | $204.17 | $204.17 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $309.03 Median $331.13 Typical High $741.31 | Professional | TC · Technical part | $309.03 | $331.13 | $741.31 |
Where North Carolina sits
The same service costs 3.9 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· 16th of 51
$550
HI $1,175DE $302
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.