How much rates vary
Facilitymedian $646 · 10th to 90th $240 to $676Professionalmedian $708 · 10th to 90th $457 to $708
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 $407.38 Median $676.08 Typical High $676.08 | Professional | None (both parts) | $407.38 | $676.08 | $676.08 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | None (both parts) | $602.56 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | None (both parts) | $467.74 | $645.65 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $501.19 | Professional | None | $346.74 | $380.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $501.19 Typical High $758.58 | Facility | None | $239.88 | $501.19 | $758.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $512.86 Median $645.65 Typical High $1,096.48 | Professional | None (both parts) | $512.86 | $645.65 | $1,096.48 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None (both parts) Typical Low $346.74 Median $457.09 Typical High $575.44 | Professional | None (both parts) | $346.74 | $457.09 | $575.44 |
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 $204.17 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $81.28 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $61.66 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $67.61 | $67.61 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $275.42 Typical High $616.60 | Professional | 26 · Professional part | $257.04 | $275.42 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $3,090.30 | Professional | 50 · Both sides | $776.25 | $977.24 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $323.59 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $257.04 | $323.59 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $128.82 Typical High $416.87 | Professional | 80 · Assistant surgeon | $102.33 | $128.82 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $91.20 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $72.44 | $91.20 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $91.20 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $91.20 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $91.20 Typical High $288.40 | Professional | AS · PA/NP assist | $72.44 | $91.20 | $288.40 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | SH · Second concurrent infusion | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | SJ · Third+ concurrent infusion | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $389.05 Median $416.87 Typical High $933.25 | Professional | TC · Technical part | $389.05 | $416.87 | $933.25 |
Where North Carolina sits
The same service costs 2.7 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· 14th of 51
$708
HI $1,096DC $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.