How much rates vary
Facilitymedian $1,585 · 10th to 90th $479 to $5,129Professionalmedian $417 · 10th to 90th $282 to $851
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 $281.84 Median $398.11 Typical High $7,244.36 | Facility | None | $281.84 | $398.11 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $630.96 | Professional | None | $281.84 | $398.11 | $630.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $5,011.87 | Facility | None | $1,258.93 | $1,949.84 | $5,011.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $870.96 | Professional | None | $295.12 | $416.87 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,454.71 | Facility | None | $602.56 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $870.96 | Professional | None | $309.03 | $398.11 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | None | $537.03 | $537.03 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $977.24 Typical High $1,778.28 | Facility | None | $457.09 | $977.24 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $537.03 | Professional | None | $371.54 | $489.78 | $537.03 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $794.33 | Professional | None | $251.19 | $380.19 | $794.33 |
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 $141.25 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $141.25 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $239.88 | $275.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $512.86 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $263.03 | $512.86 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $239.88 Typical High $323.59 | Professional | 51 · Multiple procedures | $186.21 | $239.88 | $323.59 |
Where North Carolina sits
The same service costs 6.1 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,346MT $1,043
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.