How much rates vary
Facilitymedian $676 · 10th to 90th $263 to $692Professionalmedian $692 · 10th to 90th $447 to $759
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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None (both parts) Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | None (both parts) | $426.58 | $676.08 | $676.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $891.25 | Facility | None | $741.31 | $741.31 | $891.25 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $660.69 Median $691.83 Typical High $912.01 | Professional | None (both parts) | $660.69 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | None (both parts) | $512.86 | $691.83 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $588.84 | Professional | None | $436.52 | $467.74 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $741.31 | Facility | None | $263.03 | $489.78 | $741.31 |
Medcost Setting Professional Modifier None (both parts) Typical Low $501.19 Median $630.96 Typical High $1,071.52 | Professional | None (both parts) | $501.19 | $630.96 | $1,071.52 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Facility | None | $398.11 | $398.11 | $501.19 |
United Setting Professional Modifier None (both parts) Typical Low $346.74 Median $446.68 Typical High $630.96 | Professional | None (both parts) | $346.74 | $446.68 | $630.96 |
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 $229.09 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $229.09 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $45.71 | $67.61 | $67.61 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $269.15 Typical High $602.56 | Professional | 26 · Professional part | $251.19 | $269.15 | $602.56 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $3,019.95 | Professional | 50 · Both sides | $758.58 | $954.99 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $316.23 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $251.19 | $316.23 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $125.89 Typical High $407.38 | Professional | 80 · Assistant surgeon | $100.00 | $125.89 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $89.13 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $70.79 | $89.13 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $89.13 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $89.13 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $89.13 Typical High $281.84 | Professional | AS · PA/NP assist | $70.79 | $89.13 | $281.84 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | SH · Second concurrent infusion | $251.19 | $251.19 | $251.19 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | SJ · Third+ concurrent infusion | $251.19 | $251.19 | $251.19 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $380.19 Median $407.38 Typical High $912.01 | Professional | TC · Technical part | $380.19 | $407.38 | $912.01 |
Where North Carolina sits
The same service costs 2.4 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· 18th of 51
$692
HI $1,122DC $468
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.