How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,445 to $3,631Professionalmedian $3,802 · 10th to 90th $2,344 to $4,169
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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,630.78 Typical High $3,630.78 | Professional | None (both parts) | $2,454.71 | $3,630.78 | $3,630.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Facility | None | $4,073.80 | $4,073.80 | $4,897.79 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $3,801.89 Typical High $5,011.87 | Professional | None (both parts) | $2,884.03 | $3,801.89 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,398.83 Median $2,818.38 Typical High $2,818.38 | Professional | None (both parts) | $2,398.83 | $2,818.38 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,454.71 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $4,073.80 | Facility | None | $1,445.44 | $2,691.53 | $4,073.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,754.23 Median $3,467.37 Typical High $5,888.44 | Professional | None (both parts) | $2,754.23 | $3,467.37 | $5,888.44 |
United Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,454.71 Typical High $3,467.37 | Professional | None (both parts) | $1,862.09 | $2,454.71 | $3,467.37 |
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 $371.54 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $371.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,584.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,380.38 Median $1,479.11 Typical High $3,311.31 | Professional | 26 · Professional part | $1,380.38 | $1,479.11 | $3,311.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,168.69 Median $5,128.61 Typical High $16,595.87 | Professional | 50 · Both sides | $4,168.69 | $5,128.61 | $16,595.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,380.38 Median $1,737.80 Typical High $5,623.41 | Professional | 51 · Multiple procedures | $1,380.38 | $1,737.80 | $5,623.41 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $691.83 Typical High $2,238.72 | Professional | 80 · Assistant surgeon | $549.54 | $691.83 | $2,238.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $478.63 Typical High $1,548.82 | Professional | 81 · Minimal assistant surgeon | $389.05 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $478.63 Typical High $1,548.82 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $478.63 Typical High $1,548.82 | Professional | AS · PA/NP assist | $389.05 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | SH · Second concurrent infusion | $1,380.38 | $1,380.38 | $1,380.38 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | SJ · Third+ concurrent infusion | $1,380.38 | $1,380.38 | $1,380.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,089.30 Median $2,238.72 Typical High $5,011.87 | Professional | TC · Technical part | $2,089.30 | $2,238.72 | $5,011.87 |
United Setting Professional Modifier RR · Rental Typical Low $758.58 Median $977.24 Typical High $1,348.96 | Professional | RR · Rental | $758.58 | $977.24 | $1,348.96 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $2,344.23 Typical High $3,235.94 | Professional | UE · Used equipment | $1,778.28 | $2,344.23 | $3,235.94 |
Where North Carolina sits
The same service costs 2.2 times more in Hawaii than in Colorado. 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· 15th of 51
$3,715
HI $5,370CO $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.