How much rates vary
Facilitymedian $1,622 · 10th to 90th $575 to $4,074Professionalmedian $617 · 10th to 90th $417 to $1,202
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 $436.52 Median $616.60 Typical High $5,248.07 | Facility | None | $436.52 | $616.60 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $977.24 | Professional | None | $436.52 | $616.60 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | None | $537.03 | $602.56 | $602.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,819.70 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,288.25 | Professional | None | $446.68 | $724.44 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $2,454.71 | Facility | None | $645.65 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $1,288.25 | Professional | None | $416.87 | $537.03 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | None | $724.44 | $724.44 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $1,819.70 | Facility | None | $575.44 | $977.24 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $758.58 | Professional | None | $478.63 | $645.65 | $758.58 |
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 $371.54 Median $524.81 Typical High $1,148.15 | Professional | None | $371.54 | $524.81 | $1,148.15 |
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 $218.78 Median $251.19 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $331.13 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $436.52 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $512.86 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $295.12 | $512.86 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $323.59 Typical High $380.19 | Professional | 51 · Multiple procedures | $239.88 | $323.59 | $380.19 |
Where North Carolina sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $6,580WV $1,277
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.