How much rates vary
Facilitymedian $479 · 10th to 90th $479 to $1,514Professionalmedian $661 · 10th to 90th $437 to $891
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | None (both parts) | $1,445.44 | $1,513.56 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Facility | None | $724.44 | $724.44 | $870.96 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $645.65 Median $660.69 Typical High $707.95 | Professional | None (both parts) | $645.65 | $660.69 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | None (both parts) | $407.38 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,513.56 | Facility | None | $891.25 | $1,513.56 | $1,513.56 |
Medcost Setting Professional Modifier None (both parts) Typical Low $676.08 Median $676.08 Typical High $2,089.30 | Professional | None (both parts) | $676.08 | $676.08 | $2,089.30 |
United Setting Professional Modifier None (both parts) Typical Low $331.13 Median $436.52 Typical High $602.56 | Professional | None (both parts) | $331.13 | $436.52 | $602.56 |
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 $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $269.15 Typical High $588.84 | Professional | 26 · Professional part | $269.15 | $269.15 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,000.00 Typical High $2,951.21 | Professional | 50 · Both sides | $1,000.00 | $1,000.00 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $338.84 Typical High $977.24 | Professional | 51 · Multiple procedures | $338.84 | $338.84 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $134.90 Typical High $389.05 | Professional | 80 · Assistant surgeon | $134.90 | $134.90 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $93.33 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $93.33 | $93.33 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $93.33 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $93.33 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $93.33 Typical High $275.42 | Professional | AS · PA/NP assist | $93.33 | $93.33 | $275.42 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | SH · Second concurrent infusion | $338.84 | $338.84 | $338.84 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | SJ · Third+ concurrent infusion | $338.84 | $338.84 | $338.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $407.38 Median $407.38 Typical High $870.96 | Professional | TC · Technical part | $407.38 | $407.38 | $870.96 |
Where North Carolina sits
The same service costs 3.2 times more in Michigan than in Ohio. 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· 29th of 51
$661
MI $1,413OH $447
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.