How much rates vary
Facilitymedian $1,445 · 10th to 90th $646 to $4,571Professionalmedian $891 · 10th to 90th $646 to $1,820
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 $812.83 Typical High $7,943.28 | Facility | None | $645.65 | $812.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,258.93 | Professional | None | $645.65 | $812.83 | $1,258.93 |
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 $660.69 Median $1,122.02 Typical High $1,905.46 | Professional | None | $660.69 | $1,122.02 | $1,905.46 |
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 $660.69 Median $812.83 Typical High $1,819.70 | Professional | None | $660.69 | $812.83 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $794.33 Typical High $2,137.96 | Facility | None | $588.84 | $794.33 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $977.24 | Professional | None | $741.31 | $977.24 | $977.24 |
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 $562.34 Median $776.25 Typical High $1,778.28 | Professional | None | $562.34 | $776.25 | $1,778.28 |
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 $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $575.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $398.11 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $398.11 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $489.78 Typical High $575.44 | Professional | 51 · Multiple procedures | $371.54 | $489.78 | $575.44 |
Where North Carolina sits
The same service costs 3.1 times more in Alaska 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
AK $5,990MD $1,938
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.