How much rates vary
Facilitymedian $6,026 · 10th to 90th $2,570 to $6,607Professionalmedian $6,166 · 10th to 90th $3,981 to $6,761
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 $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4,570.88 Median $6,025.60 Typical High $6,025.60 | Professional | None (both parts) | $4,570.88 | $6,025.60 | $6,025.60 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,943.28 | Facility | None | $6,606.93 | $6,606.93 | $7,943.28 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $4,677.35 Median $6,165.95 Typical High $8,128.31 | Professional | None (both parts) | $4,677.35 | $6,165.95 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $4,786.30 Median $6,606.93 Typical High $6,606.93 | Professional | None (both parts) | $4,786.30 | $6,606.93 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $4,073.80 Median $4,365.16 Typical High $6,165.95 | Professional | None | $4,073.80 | $4,365.16 | $6,165.95 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $4,365.16 Typical High $6,606.93 | Facility | None | $2,570.40 | $4,365.16 | $6,606.93 |
Medcost Setting Professional Modifier None (both parts) Typical Low $4,466.84 Median $5,623.41 Typical High $9,549.93 | Professional | None (both parts) | $4,466.84 | $5,623.41 | $9,549.93 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,466.84 | Facility | None | $3,801.89 | $3,801.89 | $4,466.84 |
United Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,981.07 Typical High $6,025.60 | Professional | None (both parts) | $3,090.30 | $3,981.07 | $6,025.60 |
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 $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,454.71 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $977.24 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $489.78 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2,238.72 Median $2,398.83 Typical High $5,370.32 | Professional | 26 · Professional part | $2,238.72 | $2,398.83 | $5,370.32 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6,760.83 Median $8,511.38 Typical High $26,915.35 | Professional | 50 · Both sides | $6,760.83 | $8,511.38 | $26,915.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,238.72 Median $2,818.38 Typical High $9,120.11 | Professional | 51 · Multiple procedures | $2,238.72 | $2,818.38 | $9,120.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $891.25 Median $1,122.02 Typical High $3,630.78 | Professional | 80 · Assistant surgeon | $891.25 | $1,122.02 | $3,630.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $630.96 Median $794.33 Typical High $2,511.89 | Professional | 81 · Minimal assistant surgeon | $630.96 | $794.33 | $2,511.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $630.96 Median $794.33 Typical High $2,511.89 | Professional | 82 · Assistant surgeon, no resident | $630.96 | $794.33 | $2,511.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $630.96 Median $794.33 Typical High $2,511.89 | Professional | AS · PA/NP assist | $630.96 | $794.33 | $2,511.89 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | SH · Second concurrent infusion | $2,238.72 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | SJ · Third+ concurrent infusion | $2,238.72 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,388.44 Median $3,630.78 Typical High $8,128.31 | Professional | TC · Technical part | $3,388.44 | $3,630.78 | $8,128.31 |
Where North Carolina sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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· 21st of 51
$6,166
MT $10,000PA $4,786
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.