How much rates vary
Facilitymedian $1,349 · 10th to 90th $550 to $1,479Professionalmedian $1,380 · 10th to 90th $871 to $1,549
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | None (both parts) | $954.99 | $1,348.96 | $1,348.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,380.38 Typical High $1,862.09 | Professional | None (both parts) | $1,071.52 | $1,380.38 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $1,071.52 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,288.25 | Professional | None | $812.83 | $870.96 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,479.11 | Facility | None | $549.54 | $1,000.00 | $1,479.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,288.25 Typical High $2,187.76 | Professional | None (both parts) | $1,023.29 | $1,288.25 | $2,187.76 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Facility | None | $954.99 | $954.99 | $1,148.15 |
United Setting Professional Modifier None (both parts) Typical Low $691.83 Median $912.01 Typical High $1,288.25 | Professional | None (both parts) | $691.83 | $912.01 | $1,288.25 |
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 $478.63 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $478.63 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $97.72 | $134.90 | $134.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $512.86 Median $549.54 Typical High $1,230.27 | Professional | 26 · Professional part | $512.86 | $549.54 | $1,230.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,905.46 Typical High $6,165.95 | Professional | 50 · Both sides | $1,548.82 | $1,905.46 | $6,165.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $645.65 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $512.86 | $645.65 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $257.04 Typical High $831.76 | Professional | 80 · Assistant surgeon | $204.17 | $257.04 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $177.83 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $144.54 | $177.83 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $177.83 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $177.83 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $177.83 Typical High $575.44 | Professional | AS · PA/NP assist | $144.54 | $177.83 | $575.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | SH · Second concurrent infusion | $512.86 | $512.86 | $512.86 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | SJ · Third+ concurrent infusion | $512.86 | $512.86 | $512.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $812.83 Typical High $1,819.70 | Professional | TC · Technical part | $776.25 | $812.83 | $1,819.70 |
Where North Carolina sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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
$1,380
HI $2,570RI $1,023
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.