How much rates vary
Facilitymedian $1,259 · 10th to 90th $631 to $1,445Professionalmedian $1,479 · 10th to 90th $912 to $1,622
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | None (both parts) | $954.99 | $1,445.44 | $1,445.44 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,479.11 Typical High $1,995.26 | Professional | None (both parts) | $1,122.02 | $1,479.11 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | None (both parts) | $912.01 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,584.89 | Facility | None | $630.96 | $1,047.13 | $1,584.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,348.96 Typical High $2,344.23 | Professional | None (both parts) | $1,096.48 | $1,348.96 | $2,344.23 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $977.24 | Facility | None | $691.83 | $691.83 | $977.24 |
United Setting Professional Modifier None (both parts) Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | None (both parts) | $741.31 | $977.24 | $1,445.44 |
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 $478.63 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $478.63 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $141.25 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $95.50 | $144.54 | $144.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $549.54 Median $588.84 Typical High $1,318.26 | Professional | 26 · Professional part | $549.54 | $588.84 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,041.74 Typical High $6,606.93 | Professional | 50 · Both sides | $1,621.81 | $2,041.74 | $6,606.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $676.08 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $549.54 | $676.08 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $870.96 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $190.55 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $151.36 | $190.55 | $616.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $190.55 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $190.55 | $616.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $190.55 Typical High $616.60 | Professional | AS · PA/NP assist | $151.36 | $190.55 | $616.60 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | SH · Second concurrent infusion | $549.54 | $549.54 | $549.54 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | SJ · Third+ concurrent infusion | $549.54 | $549.54 | $549.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $812.83 Median $870.96 Typical High $1,949.84 | Professional | TC · Technical part | $812.83 | $870.96 | $1,949.84 |
Where North Carolina sits
The same service costs 2.5 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
$1,445
AR $2,239DE $912
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.