How much rates vary
Facilitymedian $562 · 10th to 90th $214 to $589Professionalmedian $550 · 10th to 90th $355 to $603
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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $371.54 Median $524.81 Typical High $524.81 | Professional | None (both parts) | $371.54 | $524.81 | $524.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $501.19 Median $549.54 Typical High $724.44 | Professional | None (both parts) | $501.19 | $549.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $562.34 Typical High $562.34 | Professional | None (both parts) | $407.38 | $562.34 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $478.63 | Professional | None | $338.84 | $363.08 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $524.81 Typical High $630.96 | Facility | None | $213.80 | $524.81 | $630.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $524.81 Median $524.81 Typical High $851.14 | Professional | None (both parts) | $524.81 | $524.81 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $275.42 Median $354.81 Typical High $501.19 | Professional | None (both parts) | $275.42 | $354.81 | $501.19 |
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 $54.95 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $54.95 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $37.15 | $52.48 | $52.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $213.80 Typical High $478.63 | Professional | 26 · Professional part | $208.93 | $213.80 | $478.63 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $776.25 Typical High $2,398.83 | Professional | 50 · Both sides | $776.25 | $776.25 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $263.03 Typical High $794.33 | Professional | 51 · Multiple procedures | $263.03 | $263.03 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $104.71 Typical High $323.59 | Professional | 80 · Assistant surgeon | $104.71 | $104.71 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $72.44 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $72.44 | $72.44 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $72.44 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $72.44 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $72.44 Typical High $223.87 | Professional | AS · PA/NP assist | $72.44 | $72.44 | $223.87 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | SH · Second concurrent infusion | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | SJ · Third+ concurrent infusion | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $309.03 Median $323.59 Typical High $724.44 | Professional | TC · Technical part | $309.03 | $323.59 | $724.44 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in New Jersey. 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· 20th of 51
$550
HI $1,047NJ $407
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.