How much rates vary
Facilitymedian $30,200 · 10th to 90th $12,589 to $31,623Professionalmedian $30,200 · 10th to 90th $19,498 to $33,113
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 $29,512.09 Median $29,512.09 Typical High $29,512.09 | Facility | None | $29,512.09 | $29,512.09 | $29,512.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $21,877.62 Median $29,512.09 Typical High $29,512.09 | Professional | None (both parts) | $21,877.62 | $29,512.09 | $29,512.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $32,359.37 Median $32,359.37 Typical High $38,904.51 | Facility | None | $32,359.37 | $32,359.37 | $38,904.51 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $22,908.68 Median $30,199.52 Typical High $39,810.72 | Professional | None (both parts) | $22,908.68 | $30,199.52 | $39,810.72 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None (both parts) Typical Low $22,387.21 Median $30,199.52 Typical High $30,199.52 | Professional | None (both parts) | $22,387.21 | $30,199.52 | $30,199.52 |
Medcost Setting Professional Modifier None Typical Low $22,908.68 Median $24,547.09 Typical High $28,183.83 | Professional | None | $22,908.68 | $24,547.09 | $28,183.83 |
Medcost Setting Facility Modifier None Typical Low $12,589.25 Median $21,379.62 Typical High $32,359.37 | Facility | None | $12,589.25 | $21,379.62 | $32,359.37 |
Medcost Setting Professional Modifier None (both parts) Typical Low $21,877.62 Median $27,542.29 Typical High $46,773.51 | Professional | None (both parts) | $21,877.62 | $27,542.29 | $46,773.51 |
United Setting Professional Modifier None (both parts) Typical Low $15,135.61 Median $19,498.45 Typical High $29,512.09 | Professional | None (both parts) | $15,135.61 | $19,498.45 | $29,512.09 |
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 $10,964.78 Median $14,454.40 Typical High $14,454.40 | Professional | 52 · Reduced service | $10,964.78 | $14,454.40 | $14,454.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4,466.84 Median $5,888.44 Typical High $5,888.44 | Professional | 53 · Discontinued | $4,466.84 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3,311.31 Median $4,365.16 Typical High $4,365.16 | Professional | 55 · Aftercare only | $3,311.31 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,187.76 Median $2,951.21 Typical High $2,951.21 | Professional | 56 · Pre-op care only | $2,187.76 | $2,951.21 | $2,951.21 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10,964.78 Median $11,748.98 Typical High $26,302.68 | Professional | 26 · Professional part | $10,964.78 | $11,748.98 | $26,302.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $33,113.11 Median $41,686.94 Typical High $131,825.67 | Professional | 50 · Both sides | $33,113.11 | $41,686.94 | $131,825.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10,964.78 Median $13,803.84 Typical High $44,668.36 | Professional | 51 · Multiple procedures | $10,964.78 | $13,803.84 | $44,668.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4,365.16 Median $5,495.41 Typical High $17,782.79 | Professional | 80 · Assistant surgeon | $4,365.16 | $5,495.41 | $17,782.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3,090.30 Median $3,890.45 Typical High $12,302.69 | Professional | 81 · Minimal assistant surgeon | $3,090.30 | $3,890.45 | $12,302.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3,090.30 Median $3,890.45 Typical High $12,302.69 | Professional | 82 · Assistant surgeon, no resident | $3,090.30 | $3,890.45 | $12,302.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3,090.30 Median $3,890.45 Typical High $12,302.69 | Professional | AS · PA/NP assist | $3,090.30 | $3,890.45 | $12,302.69 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | SH · Second concurrent infusion | $10,964.78 | $10,964.78 | $10,964.78 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | SJ · Third+ concurrent infusion | $10,964.78 | $10,964.78 | $10,964.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16,595.87 Median $17,782.79 Typical High $39,810.72 | Professional | TC · Technical part | $16,595.87 | $17,782.79 | $39,810.72 |
Where North Carolina sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 20th of 51
$30,200
HI $47,863NJ $22,387
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.