How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,318 to $3,631Professionalmedian $3,388 · 10th to 90th $2,089 to $3,715
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 $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,238.72 Median $3,311.31 Typical High $3,311.31 | Professional | None (both parts) | $2,238.72 | $3,311.31 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $3,388.44 Typical High $4,570.88 | Professional | None (both parts) | $2,570.40 | $3,388.44 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,630.78 Typical High $3,630.78 | Professional | None (both parts) | $3,090.30 | $3,630.78 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,041.74 | $2,187.76 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,454.71 | $3,630.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $3,090.30 Typical High $5,370.32 | Professional | None (both parts) | $2,511.89 | $3,090.30 | $5,370.32 |
United Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,238.72 Typical High $3,090.30 | Professional | None (both parts) | $1,698.24 | $2,238.72 | $3,090.30 |
19 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 55 · Aftercare only Typical Low $338.84 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,445.44 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,258.93 Median $1,348.96 Typical High $3,019.95 | Professional | 26 · Professional part | $1,258.93 | $1,348.96 | $3,019.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,677.35 Typical High $15,135.61 | Professional | 50 · Both sides | $3,715.35 | $4,677.35 | $15,135.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,548.82 Typical High $5,011.87 | Professional | 51 · Multiple procedures | $1,230.27 | $1,548.82 | $5,011.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $630.96 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $501.19 | $630.96 | $1,995.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | 81 · Minimal assistant surgeon | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Professional | AS · PA/NP assist | $346.74 | $436.52 | $1,412.54 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | SH · Second concurrent infusion | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | SJ · Third+ concurrent infusion | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,862.09 Median $1,995.26 Typical High $4,466.84 | Professional | TC · Technical part | $1,862.09 | $1,995.26 | $4,466.84 |
United Setting Professional Modifier RR · Rental Typical Low $676.08 Median $891.25 Typical High $1,230.27 | Professional | RR · Rental | $676.08 | $891.25 | $1,230.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,621.81 Median $2,089.30 Typical High $2,884.03 | Professional | UE · Used equipment | $1,621.81 | $2,089.30 | $2,884.03 |
Where North Carolina sits
The same service costs 2.0 times more in Hawaii than in Washington, DC. 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· 17th of 51
$3,388
HI $4,898DC $2,399
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.