How much rates vary
Facilitymedian $1,318 · 10th to 90th $537 to $3,548Professionalmedian $1,000 · 10th to 90th $708 to $1,950
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 $707.95 Median $891.25 Typical High $7,943.28 | Facility | None | $707.95 | $891.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $977.24 | Professional | None | $707.95 | $851.14 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,819.70 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $724.44 Median $1,258.93 Typical High $2,089.30 | Professional | None | $724.44 | $1,258.93 | $2,089.30 |
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 $741.31 Median $933.25 Typical High $1,949.84 | Professional | None | $741.31 | $933.25 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
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 $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | None | $741.31 | $1,071.52 | $1,071.52 |
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 $616.60 Median $851.14 Typical High $1,905.46 | Professional | None | $616.60 | $851.14 | $1,905.46 |
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 $354.81 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $616.60 |
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 $371.54 Median $537.03 Typical High $588.84 | Professional | 51 · Multiple procedures | $371.54 | $537.03 | $588.84 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Delaware. 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 $6,113DE $1,645
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.