How much rates vary
Facilitymedian $87 · 10th to 90th $52 to $1,000Professionalmedian $69 · 10th to 90th $51 to $158
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 $52.48 Median $64.57 Typical High $7,413.10 | Facility | None | $52.48 | $64.57 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $104.71 | Professional | None | $52.48 | $64.57 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $112.20 | Professional | None | $57.54 | $95.50 | $112.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $93.33 | Facility | None | $47.86 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $165.96 | Professional | None | $52.48 | $72.44 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $144.54 | Professional | None | $51.29 | $69.18 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | None | $69.18 | $69.18 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $223.87 | Facility | None | $43.65 | $69.18 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $95.50 | Professional | None | $61.66 | $79.43 | $95.50 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $141.25 | Professional | None | $44.67 | $63.10 | $141.25 |
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 $26.30 Median $28.84 Typical High $32.36 | Professional | 52 · Reduced service | $26.30 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $12.88 | Professional | 53 · Discontinued | $10.47 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $43.65 Typical High $48.98 | Professional | 54 · Surgery only | $39.81 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.71 Typical High $9.77 | Professional | 55 · Aftercare only | $7.94 | $8.71 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.25 | $5.75 | $6.46 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $40.74 Typical High $45.71 | Professional | 78 · Unplanned return to OR | $37.15 | $40.74 | $45.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $48.98 Median $57.54 Typical High $87.10 | Professional | 59 · Distinct service | $48.98 | $57.54 | $87.10 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $21.88 Median $33.88 Typical High $33.88 | Facility | 51 · Multiple procedures | $21.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $42.66 Typical High $56.23 | Professional | 51 · Multiple procedures | $30.90 | $42.66 | $56.23 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 32nd of 51
$69.18
AK $224KY $53.70
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.