How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,096 to $2,512Professionalmedian $2,570 · 10th to 90th $1,660 to $2,818
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 $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,778.28 Median $2,511.89 Typical High $2,511.89 | Professional | None (both parts) | $1,778.28 | $2,511.89 | $2,511.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,388.44 | Facility | None | $2,818.38 | $2,818.38 | $3,388.44 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $2,570.40 Typical High $3,467.37 | Professional | None (both parts) | $1,949.84 | $2,570.40 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,398.83 Typical High $2,398.83 | Professional | None (both parts) | $1,737.80 | $2,398.83 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,344.23 | Professional | None | $2,089.30 | $2,238.72 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,096.48 | $1,862.09 | $2,754.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,398.83 Typical High $4,073.80 | Professional | None (both parts) | $1,905.46 | $2,398.83 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Facility | None | $1,445.44 | $1,445.44 | $1,698.24 |
United Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,698.24 Typical High $2,570.40 | Professional | None (both parts) | $1,288.25 | $1,698.24 | $2,570.40 |
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 $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $891.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $354.81 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $269.15 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $177.83 | $251.19 | $251.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $954.99 Median $1,023.29 Typical High $2,290.87 | Professional | 26 · Professional part | $954.99 | $1,023.29 | $2,290.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,548.13 Typical High $11,481.54 | Professional | 50 · Both sides | $2,884.03 | $3,548.13 | $11,481.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,174.90 Typical High $3,801.89 | Professional | 51 · Multiple procedures | $954.99 | $1,174.90 | $3,801.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $478.63 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $380.19 | $478.63 | $1,513.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $331.13 Typical High $1,071.52 | Professional | 81 · Minimal assistant surgeon | $269.15 | $331.13 | $1,071.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $331.13 Typical High $1,071.52 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $331.13 | $1,071.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $331.13 Typical High $1,071.52 | Professional | AS · PA/NP assist | $269.15 | $331.13 | $1,071.52 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | SH · Second concurrent infusion | $954.99 | $954.99 | $954.99 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | SJ · Third+ concurrent infusion | $954.99 | $954.99 | $954.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,412.54 Median $1,513.56 Typical High $3,388.44 | Professional | TC · Technical part | $1,412.54 | $1,513.56 | $3,388.44 |
Where North Carolina sits
The same service costs 2.2 times more in Arkansas 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· 21st of 51
$2,570
AR $3,890DE $1,738
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.