How much rates vary
Facilitymedian $9,120 · 10th to 90th $3,981 to $9,550Professionalmedian $9,772 · 10th to 90th $6,166 to $10,715
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 $9,549.93 Median $9,549.93 Typical High $9,549.93 | Facility | None | $9,549.93 | $9,549.93 | $9,549.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $6,309.57 Median $9,549.93 Typical High $9,549.93 | Professional | None (both parts) | $6,309.57 | $9,549.93 | $9,549.93 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $7,413.10 Median $9,772.37 Typical High $13,182.57 | Professional | None (both parts) | $7,413.10 | $9,772.37 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $6,606.93 Median $9,120.11 Typical High $9,120.11 | Professional | None (both parts) | $6,606.93 | $9,120.11 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $6,165.95 Median $6,760.83 Typical High $8,511.38 | Professional | None | $6,165.95 | $6,760.83 | $8,511.38 |
Medcost Setting Facility Modifier None Typical Low $3,981.07 Median $7,079.46 Typical High $10,471.29 | Facility | None | $3,981.07 | $7,079.46 | $10,471.29 |
Medcost Setting Professional Modifier None (both parts) Typical Low $7,244.36 Median $9,120.11 Typical High $15,488.17 | Professional | None (both parts) | $7,244.36 | $9,120.11 | $15,488.17 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None (both parts) Typical Low $4,897.79 Median $6,456.54 Typical High $9,120.11 | Professional | None (both parts) | $4,897.79 | $6,456.54 | $9,120.11 |
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 $3,388.44 Median $4,786.30 Typical High $4,786.30 | Professional | 52 · Reduced service | $3,388.44 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | 53 · Discontinued | $1,348.96 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,000.00 Median $1,445.44 Typical High $1,445.44 | Professional | 55 · Aftercare only | $1,000.00 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $676.08 Median $954.99 Typical High $954.99 | Professional | 56 · Pre-op care only | $676.08 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,630.78 Median $3,890.45 Typical High $8,709.64 | Professional | 26 · Professional part | $3,630.78 | $3,890.45 | $8,709.64 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $10,964.78 Median $13,489.63 Typical High $43,651.58 | Professional | 50 · Both sides | $10,964.78 | $13,489.63 | $43,651.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,630.78 Median $4,466.84 Typical High $14,454.40 | Professional | 51 · Multiple procedures | $3,630.78 | $4,466.84 | $14,454.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,445.44 Median $1,819.70 Typical High $5,754.40 | Professional | 80 · Assistant surgeon | $1,445.44 | $1,819.70 | $5,754.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,023.29 Median $1,258.93 Typical High $4,073.80 | Professional | 81 · Minimal assistant surgeon | $1,023.29 | $1,258.93 | $4,073.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,023.29 Median $1,258.93 Typical High $4,073.80 | Professional | 82 · Assistant surgeon, no resident | $1,023.29 | $1,258.93 | $4,073.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,023.29 Median $1,258.93 Typical High $4,073.80 | Professional | AS · PA/NP assist | $1,023.29 | $1,258.93 | $4,073.80 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | SH · Second concurrent infusion | $3,630.78 | $3,630.78 | $3,630.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | SJ · Third+ concurrent infusion | $3,630.78 | $3,630.78 | $3,630.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $5,370.32 Median $5,754.40 Typical High $12,882.50 | Professional | TC · Technical part | $5,370.32 | $5,754.40 | $12,882.50 |
Where North Carolina sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 18th of 51
$9,772
MT $16,596DE $6,607
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.