How much rates vary
Facilitymedian $158 · 10th to 90th $76 to $891Professionalmedian $158 · 10th to 90th $102 to $331
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 $100.00 Median $162.18 Typical High $7,413.10 | Facility | None | $100.00 | $162.18 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $257.04 | Professional | None | $100.00 | $162.18 | $257.04 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $354.81 | Professional | None | $109.65 | $158.49 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $162.18 Typical High $257.04 | Facility | None | $56.23 | $162.18 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $331.13 | Professional | None | $109.65 | $144.54 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | None | $199.53 | $199.53 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $245.47 | Facility | None | $70.79 | $102.33 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $194.98 | Professional | None | $134.90 | $173.78 | $194.98 |
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 $93.33 Median $144.54 Typical High $302.00 | Professional | None | $93.33 | $144.54 | $302.00 |
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 $50.12 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $19.95 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $75.86 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $15.14 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.00 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $70.79 | $97.72 | $112.20 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 79 · Unrelated procedure after surgery | $154.88 | $154.88 | $154.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $33.11 Median $51.29 Typical High $123.03 | Facility | 51 · Multiple procedures | $33.11 | $51.29 | $123.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $87.10 Typical High $107.15 | Professional | 51 · Multiple procedures | $67.61 | $87.10 | $107.15 |
Where North Carolina sits
The same service costs 3.5 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· 27th of 51
$158
AK $427KY $123
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.