How much rates vary
Facilitymedian $525 · 10th to 90th $257 to $631Professionalmedian $646 · 10th to 90th $407 to $724
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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $416.87 Median $630.96 Typical High $630.96 | Professional | None (both parts) | $416.87 | $630.96 | $630.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $645.65 Typical High $870.96 | Professional | None (both parts) | $602.56 | $645.65 | $870.96 |
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 $407.38 Median $436.52 Typical High $575.44 | Professional | None | $407.38 | $436.52 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $630.96 Typical High $758.58 | Facility | None | $257.04 | $630.96 | $758.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $630.96 Median $630.96 Typical High $1,023.29 | Professional | None (both parts) | $630.96 | $630.96 | $1,023.29 |
United Setting Professional Modifier None (both parts) Typical Low $323.59 Median $426.58 Typical High $602.56 | Professional | None (both parts) | $323.59 | $426.58 | $602.56 |
12 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 55 · Aftercare only Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $44.67 | $63.10 | $63.10 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $257.04 Typical High $575.44 | Professional | 26 · Professional part | $251.19 | $257.04 | $575.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $933.25 Typical High $2,884.03 | Professional | 50 · Both sides | $933.25 | $933.25 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $309.03 Typical High $954.99 | Professional | 51 · Multiple procedures | $309.03 | $309.03 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $125.89 Typical High $389.05 | Professional | 80 · Assistant surgeon | $125.89 | $125.89 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $87.10 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $87.10 | $87.10 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $87.10 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $87.10 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $87.10 Typical High $269.15 | Professional | AS · PA/NP assist | $87.10 | $87.10 | $269.15 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | SH · Second concurrent infusion | $309.03 | $309.03 | $309.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | SJ · Third+ concurrent infusion | $309.03 | $309.03 | $309.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $371.54 Median $389.05 Typical High $851.14 | Professional | TC · Technical part | $371.54 | $389.05 | $851.14 |
Where North Carolina sits
The same service costs 3.2 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· 18th of 51
$646
HI $1,259DE $389
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.