How much rates vary
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 $162.18 Median $239.88 Typical High $7,413.10 | Facility | None | $162.18 | $239.88 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $275.42 | Professional | None | $162.18 | $239.88 | $275.42 |
BCBS Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $275.42 | Facility | None | $138.04 | $204.17 | $275.42 |
BCBS Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $524.81 | Professional | None | $173.78 | $288.40 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $549.54 | Facility | None | $169.82 | $269.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $524.81 | Professional | None | $181.97 | $229.09 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | None | $316.23 | $316.23 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $389.05 | Facility | None | $138.04 | $199.53 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $338.84 | Professional | None | $213.80 | $302.00 | $338.84 |
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 $151.36 Median $223.87 Typical High $457.09 | Professional | None | $151.36 | $223.87 | $457.09 |
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 $81.28 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $81.28 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $32.36 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $120.23 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $23.99 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.22 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $112.20 | $147.91 | $165.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $64.57 Median $100.00 Typical High $190.55 | Facility | 51 · Multiple procedures | $64.57 | $100.00 | $190.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $147.91 Typical High $173.78 | Professional | 51 · Multiple procedures | $107.15 | $147.91 | $173.78 |
Where North Carolina sits
The same service costs 3.5 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.
North Carolina· 30th of 51
$240
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.