How much rates vary
Facilitymedian $12,589 · 10th to 90th $5,623 to $13,490Professionalmedian $13,804 · 10th to 90th $8,710 to $15,136
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 $13,489.63 Median $13,489.63 Typical High $13,489.63 | Facility | None | $13,489.63 | $13,489.63 | $13,489.63 |
Aetna Setting Professional Modifier None (both parts) Typical Low $9,549.93 Median $13,489.63 Typical High $13,489.63 | Professional | None (both parts) | $9,549.93 | $13,489.63 | $13,489.63 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $10,471.29 Median $13,803.84 Typical High $18,197.01 | Professional | None (both parts) | $10,471.29 | $13,803.84 | $18,197.01 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $9,120.11 Median $12,589.25 Typical High $12,589.25 | Professional | None (both parts) | $9,120.11 | $12,589.25 | $12,589.25 |
Medcost Setting Professional Modifier None Typical Low $10,715.19 Median $11,481.54 Typical High $12,882.50 | Professional | None | $10,715.19 | $11,481.54 | $12,882.50 |
Medcost Setting Facility Modifier None Typical Low $5,623.41 Median $9,772.37 Typical High $14,791.08 | Facility | None | $5,623.41 | $9,772.37 | $14,791.08 |
Medcost Setting Professional Modifier None (both parts) Typical Low $10,232.93 Median $12,589.25 Typical High $21,877.62 | Professional | None (both parts) | $10,232.93 | $12,589.25 | $21,877.62 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None (both parts) Typical Low $6,918.31 Median $8,912.51 Typical High $13,182.57 | Professional | None (both parts) | $6,918.31 | $8,912.51 | $13,182.57 |
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 $4,786.30 Median $6,760.83 Typical High $6,760.83 | Professional | 52 · Reduced service | $4,786.30 | $6,760.83 | $6,760.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | 53 · Discontinued | $1,905.46 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 55 · Aftercare only | $1,445.44 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | 56 · Pre-op care only | $954.99 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5,011.87 Median $5,370.32 Typical High $12,022.64 | Professional | 26 · Professional part | $5,011.87 | $5,370.32 | $12,022.64 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $15,135.61 Median $19,054.61 Typical High $61,659.50 | Professional | 50 · Both sides | $15,135.61 | $19,054.61 | $61,659.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5,128.61 Median $6,309.57 Typical High $20,417.38 | Professional | 51 · Multiple procedures | $5,128.61 | $6,309.57 | $20,417.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2,041.74 Median $2,511.89 Typical High $8,128.31 | Professional | 80 · Assistant surgeon | $2,041.74 | $2,511.89 | $8,128.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,412.54 Median $1,778.28 Typical High $5,754.40 | Professional | 81 · Minimal assistant surgeon | $1,412.54 | $1,778.28 | $5,754.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,412.54 Median $1,778.28 Typical High $5,754.40 | Professional | 82 · Assistant surgeon, no resident | $1,412.54 | $1,778.28 | $5,754.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,412.54 Median $1,778.28 Typical High $5,754.40 | Professional | AS · PA/NP assist | $1,412.54 | $1,778.28 | $5,754.40 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | SH · Second concurrent infusion | $5,128.61 | $5,128.61 | $5,128.61 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | SJ · Third+ concurrent infusion | $5,128.61 | $5,128.61 | $5,128.61 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7,585.78 Median $8,128.31 Typical High $18,197.01 | Professional | TC · Technical part | $7,585.78 | $8,128.31 | $18,197.01 |
Where North Carolina sits
The same service costs 2.5 times more in Montana than in Florida. 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· 19th of 51
$13,490
MT $22,387FL $9,120
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.