How much rates vary
Facilitymedian $1,318 · 10th to 90th $575 to $3,020Professionalmedian $1,175 · 10th to 90th $794 to $2,344
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 $794.33 Median $954.99 Typical High $7,762.47 | Facility | None | $794.33 | $954.99 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,548.82 | Professional | None | $794.33 | $954.99 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,202.26 | $1,698.24 |
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 $954.99 Median $1,445.44 Typical High $2,398.83 | Professional | None | $954.99 | $1,445.44 | $2,398.83 |
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 $977.24 Median $1,071.52 Typical High $2,187.76 | Professional | None | $977.24 | $1,071.52 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
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 $933.25 Median $1,230.27 Typical High $1,445.44 | Professional | None | $933.25 | $1,230.27 | $1,445.44 |
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 $724.44 Median $954.99 Typical High $2,089.30 | Professional | None | $724.44 | $954.99 | $2,089.30 |
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 $398.11 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $676.08 |
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 $467.74 Median $616.60 Typical High $870.96 | Professional | 51 · Multiple procedures | $467.74 | $616.60 | $870.96 |
Where North Carolina sits
The same service costs 4.5 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· 18th of 51
$1,175
AK $3,311TX $741
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.