How much rates vary
Facilitymedian $7,762 · 10th to 90th $3,388 to $8,128Professionalmedian $8,128 · 10th to 90th $5,248 to $8,913
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 $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
Aetna Setting Professional Modifier None (both parts) Typical Low $5,623.41 Median $7,762.47 Typical High $7,762.47 | Professional | None (both parts) | $5,623.41 | $7,762.47 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $6,165.95 Median $8,128.31 Typical High $10,715.19 | Professional | None (both parts) | $6,165.95 | $8,128.31 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $5,888.44 Median $8,128.31 Typical High $8,128.31 | Professional | None (both parts) | $5,888.44 | $8,128.31 | $8,128.31 |
Medcost Setting Professional Modifier None Typical Low $5,495.41 Median $5,888.44 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,888.44 | $7,585.78 |
Medcost Setting Facility Modifier None Typical Low $3,388.44 Median $5,754.40 Typical High $8,709.64 | Facility | None | $3,388.44 | $5,754.40 | $8,709.64 |
Medcost Setting Professional Modifier None (both parts) Typical Low $5,888.44 Median $7,413.10 Typical High $12,589.25 | Professional | None (both parts) | $5,888.44 | $7,413.10 | $12,589.25 |
United Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,248.07 | Facility | None | $4,466.84 | $4,466.84 | $5,248.07 |
United Setting Professional Modifier None (both parts) Typical Low $4,073.80 Median $5,248.07 Typical High $7,943.28 | Professional | None (both parts) | $4,073.80 | $5,248.07 | $7,943.28 |
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 $3,019.95 Median $3,890.45 Typical High $3,890.45 | Professional | 52 · Reduced service | $3,019.95 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,584.89 Typical High $1,584.89 | Professional | 53 · Discontinued | $1,202.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $912.01 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $602.56 Median $776.25 Typical High $776.25 | Professional | 56 · Pre-op care only | $602.56 | $776.25 | $776.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2,951.21 Median $3,162.28 Typical High $7,079.46 | Professional | 26 · Professional part | $2,951.21 | $3,162.28 | $7,079.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $8,912.51 Median $10,964.78 Typical High $35,481.34 | Professional | 50 · Both sides | $8,912.51 | $10,964.78 | $35,481.34 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,951.21 Median $3,715.35 Typical High $12,022.64 | Professional | 51 · Multiple procedures | $2,951.21 | $3,715.35 | $12,022.64 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,174.90 Median $1,479.11 Typical High $4,786.30 | Professional | 80 · Assistant surgeon | $1,174.90 | $1,479.11 | $4,786.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $831.76 Median $1,023.29 Typical High $3,311.31 | Professional | 81 · Minimal assistant surgeon | $831.76 | $1,023.29 | $3,311.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $831.76 Median $1,023.29 Typical High $3,311.31 | Professional | 82 · Assistant surgeon, no resident | $831.76 | $1,023.29 | $3,311.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $831.76 Median $1,023.29 Typical High $3,311.31 | Professional | AS · PA/NP assist | $831.76 | $1,023.29 | $3,311.31 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | SH · Second concurrent infusion | $2,951.21 | $2,951.21 | $2,951.21 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | SJ · Third+ concurrent infusion | $2,951.21 | $2,951.21 | $2,951.21 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,466.84 Median $4,786.30 Typical High $10,715.19 | Professional | TC · Technical part | $4,466.84 | $4,786.30 | $10,715.19 |
Where North Carolina sits
The same service costs 2.5 times more in Montana than in West Virginia. 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
$8,128
MT $14,454WV $5,888
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.