How much rates vary
Facilitymedian $513 · 10th to 90th $204 to $525Professionalmedian $525 · 10th to 90th $324 to $575
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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $331.13 Median $512.86 Typical High $512.86 | Professional | None (both parts) | $331.13 | $512.86 | $512.86 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $398.11 Median $524.81 Typical High $707.95 | Professional | None (both parts) | $398.11 | $524.81 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $389.05 Median $524.81 Typical High $524.81 | Professional | None (both parts) | $389.05 | $524.81 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | None | $380.19 | $407.38 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $371.54 Typical High $562.34 | Facility | None | $204.17 | $371.54 | $562.34 |
Medcost Setting Professional Modifier None (both parts) Typical Low $389.05 Median $478.63 Typical High $831.76 | Professional | None (both parts) | $389.05 | $478.63 | $831.76 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Facility | None | $302.00 | $302.00 | $380.19 |
United Setting Professional Modifier None (both parts) Typical Low $263.03 Median $346.74 Typical High $489.78 | Professional | None (both parts) | $263.03 | $346.74 | $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 $177.83 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $52.48 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $194.98 Median $208.93 Typical High $457.09 | Professional | 26 · Professional part | $194.98 | $208.93 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $724.44 Typical High $2,344.23 | Professional | 50 · Both sides | $575.44 | $724.44 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $239.88 Typical High $776.25 | Professional | 51 · Multiple procedures | $194.98 | $239.88 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $95.50 Typical High $309.03 | Professional | 80 · Assistant surgeon | $77.62 | $95.50 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $67.61 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $53.70 | $67.61 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $67.61 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $67.61 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $67.61 Typical High $218.78 | Professional | AS · PA/NP assist | $53.70 | $67.61 | $218.78 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | SH · Second concurrent infusion | $194.98 | $194.98 | $194.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | SJ · Third+ concurrent infusion | $194.98 | $194.98 | $194.98 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $288.40 Median $309.03 Typical High $691.83 | Professional | TC · Technical part | $288.40 | $309.03 | $691.83 |
Where North Carolina sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 17th of 51
$525
HI $851PA $363
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.