How much rates vary
Facilitymedian $2,239 · 10th to 90th $955 to $2,291Professionalmedian $2,344 · 10th to 90th $1,549 to $2,344
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,290.87 Typical High $2,290.87 | Professional | None (both parts) | $1,659.59 | $2,290.87 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,344.23 Typical High $2,344.23 | Professional | None (both parts) | $2,041.74 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,238.72 Typical High $2,238.72 | Professional | None (both parts) | $1,905.46 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,513.56 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,511.89 | Facility | None | $954.99 | $1,698.24 | $2,511.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,187.76 Typical High $3,715.35 | Professional | None (both parts) | $1,737.80 | $2,187.76 | $3,715.35 |
United Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,548.82 Typical High $2,238.72 | Professional | None (both parts) | $1,174.90 | $1,548.82 | $2,238.72 |
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 $257.04 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $257.04 | $346.74 | $346.74 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | KM · Facial prosthesis, new mold | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | KN · Facial prosthesis, prior mold | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | KM · Facial prosthesis, new mold | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | KN · Facial prosthesis, prior mold | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | KM · Facial prosthesis, new mold | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | KN · Facial prosthesis, prior mold | $1,047.13 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $870.96 Median $933.25 Typical High $2,089.30 | Professional | 26 · Professional part | $870.96 | $933.25 | $2,089.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,235.94 Typical High $10,471.29 | Professional | 50 · Both sides | $2,570.40 | $3,235.94 | $10,471.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,071.52 Typical High $3,467.37 | Professional | 51 · Multiple procedures | $870.96 | $1,071.52 | $3,467.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $346.74 | $436.52 | $1,380.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $302.00 Typical High $977.24 | Professional | 81 · Minimal assistant surgeon | $239.88 | $302.00 | $977.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $302.00 Typical High $977.24 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $302.00 | $977.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $302.00 Typical High $977.24 | Professional | AS · PA/NP assist | $239.88 | $302.00 | $977.24 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | SH · Second concurrent infusion | $870.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | SJ · Third+ concurrent infusion | $870.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,288.25 Median $1,380.38 Typical High $3,090.30 | Professional | TC · Technical part | $1,288.25 | $1,380.38 | $3,090.30 |
United Setting Professional Modifier RR · Rental Typical Low $467.74 Median $616.60 Typical High $891.25 | Professional | RR · Rental | $467.74 | $616.60 | $891.25 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $1,479.11 Typical High $2,089.30 | Professional | UE · Used equipment | $1,122.02 | $1,479.11 | $2,089.30 |
Where North Carolina sits
The same service costs 2.1 times more in Wisconsin than in Kentucky. 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· 19th of 51
$2,344
WI $3,715KY $1,778
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.