How much rates vary
Facilitymedian $1,288 · 10th to 90th $562 to $3,020Professionalmedian $851 · 10th to 90th $589 to $1,660
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 $588.84 Median $741.31 Typical High $7,244.36 | Facility | None | $588.84 | $741.31 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,202.26 | Professional | None | $588.84 | $741.31 | $1,202.26 |
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 $630.96 Median $977.24 Typical High $1,778.28 | Professional | None | $630.96 | $977.24 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,238.72 | Facility | None | $602.56 | $1,737.80 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,659.59 | Professional | None | $660.69 | $776.25 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | None | $891.25 | $891.25 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $2,137.96 | Facility | None | $549.54 | $933.25 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $933.25 | Professional | None | $724.44 | $891.25 | $933.25 |
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 $512.86 Median $724.44 Typical High $1,621.81 | Professional | None | $512.86 | $724.44 | $1,621.81 |
9 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 $295.12 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $295.12 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $524.81 |
Ambetter Setting Professional Modifier 58 · Staged procedure + 59 · Distinct service Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 58 · Staged procedure + 59 · Distinct service | $831.76 | $831.76 | $831.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $263.03 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $457.09 Typical High $575.44 | Professional | 51 · Multiple procedures | $363.08 | $457.09 | $575.44 |
Where North Carolina sits
The same service costs 4.2 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
$851
AK $2,455TX $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.