How much rates vary
Facilitymedian $479 · 10th to 90th $120 to $1,318Professionalmedian $447 · 10th to 90th $275 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 $275.42 Median $426.58 Typical High $4,365.16 | Facility | None | $275.42 | $426.58 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $691.83 | Professional | None | $275.42 | $426.58 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $707.95 | Professional | None | $389.05 | $389.05 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $177.83 Median $275.42 Typical High $707.95 | Facility | None | $177.83 | $275.42 | $707.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $891.25 | Professional | None | $281.84 | $537.03 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $1,737.80 | Facility | None | $478.63 | $707.95 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $831.76 | Professional | None | $309.03 | $436.52 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $512.86 Typical High $933.25 | Facility | None | $165.96 | $512.86 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $588.84 | Professional | None | $389.05 | $478.63 | $588.84 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $758.58 | Professional | None | $239.88 | $380.19 | $758.58 |
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 $138.04 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $138.04 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $245.47 | $295.12 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $77.62 Median $251.19 Typical High $467.74 | Facility | 51 · Multiple procedures | $77.62 | $251.19 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $239.88 Typical High $309.03 | Professional | 51 · Multiple procedures | $194.98 | $239.88 | $309.03 |
Where North Carolina sits
The same service costs 4.1 times more in New York than in Maryland. 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
NY $3,010MD $740
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.