How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $5,248Professionalmedian $646 · 10th to 90th $407 to $1,202
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 $407.38 Median $512.86 Typical High $1,584.89 | Facility | None | $407.38 | $512.86 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $870.96 | Professional | None | $407.38 | $512.86 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $831.76 | Professional | None | $512.86 | $562.34 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,187.76 | $5,495.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,258.93 | Professional | None | $524.81 | $812.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,187.76 Typical High $3,162.28 | Facility | None | $645.65 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,202.26 | Professional | None | $398.11 | $549.54 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $2,187.76 | Facility | None | $575.44 | $977.24 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $831.76 | Professional | None | $446.68 | $575.44 | $831.76 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $1,122.02 | Professional | None | $380.19 | $524.81 | $1,122.02 |
10 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 $204.17 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $354.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,737.80 Typical High $4,265.80 | Facility | 50 · Both sides | $891.25 | $1,737.80 | $4,265.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $575.44 Typical High $1,412.54 | Facility | 51 · Multiple procedures | $295.12 | $575.44 | $1,412.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $851.14 Typical High $2,137.96 | Professional | 50 · Both sides | $660.69 | $851.14 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $281.84 Typical High $707.95 | Professional | 51 · Multiple procedures | $223.87 | $281.84 | $707.95 |
Where North Carolina sits
The same service costs 7.2 times more in Vermont than in Maine. 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
VT $9,370ME $1,294
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.