How much rates vary
Facilitymedian $1,479 · 10th to 90th $759 to $2,042Professionalmedian $2,089 · 10th to 90th $1,318 to $2,239
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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | None (both parts) | $1,288.25 | $2,041.74 | $2,041.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,691.53 | Facility | None | $2,238.72 | $2,238.72 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,089.30 Typical High $2,290.87 | Professional | None (both parts) | $2,041.74 | $2,089.30 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $1,258.93 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,318.26 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $2,238.72 | Facility | None | $758.58 | $1,479.11 | $2,238.72 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,905.46 Typical High $3,235.94 | Professional | None (both parts) | $1,513.56 | $1,905.46 | $3,235.94 |
United Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,348.96 Typical High $1,819.70 | Professional | None (both parts) | $1,023.29 | $1,348.96 | $1,819.70 |
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 $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $645.65 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $257.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $194.98 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $204.17 | $204.17 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $758.58 Median $812.83 Typical High $1,819.70 | Professional | 26 · Professional part | $758.58 | $812.83 | $1,819.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,884.03 Typical High $9,120.11 | Professional | 50 · Both sides | $2,290.87 | $2,884.03 | $9,120.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $954.99 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $758.58 | $954.99 | $3,090.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $380.19 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $302.00 | $380.19 | $1,230.27 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $269.15 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $213.80 | $269.15 | $851.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $269.15 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $269.15 | $851.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $269.15 Typical High $851.14 | Professional | AS · PA/NP assist | $213.80 | $269.15 | $851.14 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | SH · Second concurrent infusion | $758.58 | $758.58 | $758.58 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | SJ · Third+ concurrent infusion | $758.58 | $758.58 | $758.58 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,148.15 Median $1,230.27 Typical High $2,754.23 | Professional | TC · Technical part | $1,148.15 | $1,230.27 | $2,754.23 |
Where North Carolina sits
The same service costs 2.6 times more in Montana than in New York. 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· 14th of 51
$2,089
MT $2,754NY $1,072
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.