How much rates vary
Facilitymedian $851 · 10th to 90th $309 to $2,570Professionalmedian $331 · 10th to 90th $224 to $661
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 $239.88 Median $309.03 Typical High $1,584.89 | Facility | None | $239.88 | $309.03 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $501.19 | Professional | None | $239.88 | $309.03 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $309.03 Typical High $398.11 | Professional | None | $141.25 | $309.03 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,715.35 | Facility | None | $933.25 | $1,445.44 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $691.83 | Professional | None | $229.09 | $354.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $676.08 | Professional | None | $204.17 | $275.42 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | None | $323.59 | $323.59 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $1,148.15 | Facility | None | $371.54 | $707.95 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $436.52 | Professional | None | $251.19 | $363.08 | $436.52 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $660.69 | Professional | None | $204.17 | $281.84 | $660.69 |
8 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 $120.23 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $218.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $398.11 Typical High $724.44 | Facility | 51 · Multiple procedures | $263.03 | $398.11 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $177.83 Typical High $251.19 | Professional | 51 · Multiple procedures | $125.89 | $177.83 | $251.19 |
Where North Carolina sits
The same service costs 4.8 times more in Alaska 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· 26th of 51
$347
AK $1,202KY $251
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.