How much rates vary
Facilitymedian $479 · 10th to 90th $120 to $1,288Professionalmedian $380 · 10th to 90th $251 to $813
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 $389.05 Typical High $5,248.07 | Facility | None | $239.88 | $389.05 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $602.56 | Professional | None | $239.88 | $389.05 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $575.44 | Professional | None | $331.13 | $436.52 | $575.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $1,071.52 | Facility | None | $269.15 | $416.87 | $1,071.52 |
BCBS North Carolina Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $851.14 | Professional | None | $281.84 | $389.05 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,995.26 | Facility | None | $478.63 | $691.83 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $758.58 | Professional | None | $302.00 | $380.19 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $478.63 Typical High $933.25 | Facility | None | $239.88 | $478.63 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $537.03 | Professional | None | $323.59 | $478.63 | $537.03 |
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 $234.42 Median $346.74 Typical High $676.08 | Professional | None | $234.42 | $346.74 | $676.08 |
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 $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $169.82 | $223.87 | $275.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $120.23 Median $288.40 Typical High $467.74 | Facility | 51 · Multiple procedures | $120.23 | $288.40 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $239.88 Typical High $302.00 | Professional | 51 · Multiple procedures | $158.49 | $239.88 | $302.00 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$389
AK $1,000UT $302
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.