How much rates vary
Facilitymedian $1,259 · 10th to 90th $575 to $3,020Professionalmedian $871 · 10th to 90th $646 to $1,698
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 $645.65 Median $741.31 Typical High $6,760.83 | Facility | None | $645.65 | $741.31 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,202.26 | Professional | None | $645.65 | $741.31 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,778.28 | Facility | None | $891.25 | $1,318.26 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,778.28 | Professional | None | $691.83 | $912.01 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $2,238.72 | Facility | None | $645.65 | $1,862.09 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,698.24 | Professional | None | $724.44 | $794.33 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | None | $1,096.48 | $1,096.48 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,137.96 | Facility | None | $588.84 | $977.24 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,258.93 | Professional | None | $724.44 | $954.99 | $1,258.93 |
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 $562.34 Median $741.31 Typical High $1,659.59 | Professional | None | $562.34 | $741.31 | $1,659.59 |
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 $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $524.81 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $478.63 Typical High $676.08 | Professional | 51 · Multiple procedures | $363.08 | $478.63 | $676.08 |
Where North Carolina sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 24th of 51
$891
AK $2,692TX $589
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.