How much rates vary
Facilitymedian $5,623 · 10th to 90th $5,623 to $7,943Professionalmedian $7,762 · 10th to 90th $5,012 to $8,318
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 $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4,786.30 Median $7,585.78 Typical High $7,585.78 | Professional | None (both parts) | $4,786.30 | $7,585.78 | $7,585.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,232.93 | Facility | None | $8,511.38 | $8,511.38 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $7,585.78 Median $7,762.47 Typical High $8,317.64 | Professional | None (both parts) | $7,585.78 | $7,762.47 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None (both parts) Typical Low $4,786.30 Median $5,623.41 Typical High $5,623.41 | Professional | None (both parts) | $4,786.30 | $5,623.41 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $6,606.93 Median $7,585.78 Typical High $9,120.11 | Facility | None | $6,606.93 | $7,585.78 | $9,120.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $7,943.28 Median $7,943.28 Typical High $12,589.25 | Professional | None (both parts) | $7,943.28 | $7,943.28 | $12,589.25 |
United Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $5,011.87 Typical High $7,079.46 | Professional | None (both parts) | $3,890.45 | $5,011.87 | $7,079.46 |
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 $2,511.89 Median $3,801.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $2,511.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 53 · Discontinued | $1,000.00 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $1,122.02 Typical High $1,122.02 | Professional | 55 · Aftercare only | $758.58 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $758.58 Typical High $758.58 | Professional | 56 · Pre-op care only | $501.19 | $758.58 | $758.58 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,162.28 Median $3,162.28 Typical High $6,760.83 | Professional | 26 · Professional part | $3,162.28 | $3,162.28 | $6,760.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $12,022.64 Median $12,022.64 Typical High $34,673.69 | Professional | 50 · Both sides | $12,022.64 | $12,022.64 | $34,673.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,981.07 Median $3,981.07 Typical High $11,481.54 | Professional | 51 · Multiple procedures | $3,981.07 | $3,981.07 | $11,481.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,584.89 Median $1,584.89 Typical High $4,570.88 | Professional | 80 · Assistant surgeon | $1,584.89 | $1,584.89 | $4,570.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,122.02 Median $1,122.02 Typical High $3,235.94 | Professional | 81 · Minimal assistant surgeon | $1,122.02 | $1,122.02 | $3,235.94 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,122.02 Median $1,122.02 Typical High $3,235.94 | Professional | 82 · Assistant surgeon, no resident | $1,122.02 | $1,122.02 | $3,235.94 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,122.02 Median $1,122.02 Typical High $3,235.94 | Professional | AS · PA/NP assist | $1,122.02 | $1,122.02 | $3,235.94 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | SH · Second concurrent infusion | $3,981.07 | $3,981.07 | $3,981.07 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | SJ · Third+ concurrent infusion | $3,981.07 | $3,981.07 | $3,981.07 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,786.30 Median $4,786.30 Typical High $10,232.93 | Professional | TC · Technical part | $4,786.30 | $4,786.30 | $10,232.93 |
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· 15th of 51
$7,762
MT $10,715NY $4,169
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.