How much rates vary
Facilitymedian $1,000 · 10th to 90th $257 to $2,239Professionalmedian $229 · 10th to 90th $174 to $490
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 $173.78 Median $229.09 Typical High $4,365.16 | Facility | None | $173.78 | $229.09 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $371.54 | Professional | None | $173.78 | $229.09 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $257.04 | Professional | None | $165.96 | $223.87 | $257.04 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $524.81 | Professional | None | $177.83 | $234.42 | $524.81 |
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 $186.21 Median $234.42 Typical High $501.19 | Professional | None | $186.21 | $234.42 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $338.84 | Professional | None | $275.42 | $275.42 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $707.95 Typical High $1,202.26 | Facility | None | $275.42 | $707.95 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $309.03 | Professional | None | $223.87 | $275.42 | $309.03 |
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 $147.91 Median $218.78 Typical High $478.63 | Professional | None | $147.91 | $218.78 | $478.63 |
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 $85.11 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $85.11 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $34.67 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $128.82 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.38 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $120.23 | $141.25 | $162.18 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $426.58 Typical High $724.44 | Facility | 51 · Multiple procedures | $263.03 | $426.58 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $138.04 Typical High $186.21 | Professional | 51 · Multiple procedures | $109.65 | $138.04 | $186.21 |
Where North Carolina sits
The same service costs 4.7 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· 30th of 51
$240
AK $871KY $186
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.