How much rates vary
Facilitymedian $7,244 · 10th to 90th $2,951 to $7,943Professionalmedian $8,318 · 10th to 90th $5,129 to $9,120
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 $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $5,128.61 Median $7,943.28 Typical High $7,943.28 | Professional | None (both parts) | $5,128.61 | $7,943.28 | $7,943.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $10,715.19 | Facility | None | $8,912.51 | $8,912.51 | $10,715.19 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $6,309.57 Median $8,317.64 Typical High $10,964.78 | Professional | None (both parts) | $6,309.57 | $8,317.64 | $10,964.78 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $7,244.36 Typical High $7,244.36 | Professional | None (both parts) | $5,248.07 | $7,244.36 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $4,365.16 Median $4,677.35 Typical High $6,760.83 | Professional | None | $4,365.16 | $4,677.35 | $6,760.83 |
Medcost Setting Facility Modifier None Typical Low $2,951.21 Median $5,888.44 Typical High $8,912.51 | Facility | None | $2,951.21 | $5,888.44 | $8,912.51 |
Medcost Setting Professional Modifier None (both parts) Typical Low $6,025.60 Median $7,585.78 Typical High $12,882.50 | Professional | None (both parts) | $6,025.60 | $7,585.78 | $12,882.50 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,128.61 | Facility | None | $4,365.16 | $4,365.16 | $5,128.61 |
United Setting Professional Modifier None (both parts) Typical Low $4,073.80 Median $5,370.32 Typical High $7,079.46 | Professional | None (both parts) | $4,073.80 | $5,370.32 | $7,079.46 |
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 $2,630.27 Median $3,981.07 Typical High $3,981.07 | Professional | 52 · Reduced service | $2,630.27 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,621.81 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,047.13 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $794.33 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | 56 · Pre-op care only | $524.81 | $794.33 | $794.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,019.95 Median $3,235.94 Typical High $7,244.36 | Professional | 26 · Professional part | $3,019.95 | $3,235.94 | $7,244.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $9,120.11 Median $11,220.18 Typical High $36,307.81 | Professional | 50 · Both sides | $9,120.11 | $11,220.18 | $36,307.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,019.95 Median $3,801.89 Typical High $12,302.69 | Professional | 51 · Multiple procedures | $3,019.95 | $3,801.89 | $12,302.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,202.26 Median $1,513.56 Typical High $4,897.79 | Professional | 80 · Assistant surgeon | $1,202.26 | $1,513.56 | $4,897.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $851.14 Median $1,047.13 Typical High $3,388.44 | Professional | 81 · Minimal assistant surgeon | $851.14 | $1,047.13 | $3,388.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $851.14 Median $1,047.13 Typical High $3,388.44 | Professional | 82 · Assistant surgeon, no resident | $851.14 | $1,047.13 | $3,388.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $851.14 Median $1,047.13 Typical High $3,388.44 | Professional | AS · PA/NP assist | $851.14 | $1,047.13 | $3,388.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | SH · Second concurrent infusion | $3,019.95 | $3,019.95 | $3,019.95 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | SJ · Third+ concurrent infusion | $3,019.95 | $3,019.95 | $3,019.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,570.88 Median $4,897.79 Typical High $10,964.78 | Professional | TC · Technical part | $4,570.88 | $4,897.79 | $10,964.78 |
Where North Carolina sits
The same service costs 2.1 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· 16th of 51
$8,128
HI $11,220NJ $5,248
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.