How much rates vary
Facilitymedian $1,862 · 10th to 90th $759 to $4,898Professionalmedian $1,122 · 10th to 90th $724 to $2,042
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 $660.69 Median $812.83 Typical High $5,248.07 | Facility | None | $660.69 | $812.83 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,148.15 | Professional | None | $660.69 | $812.83 | $1,148.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,754.23 | Facility | None | $1,348.96 | $1,995.26 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,137.96 | Professional | None | $912.01 | $1,380.38 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,162.28 | Facility | None | $794.33 | $2,454.71 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,995.26 | Professional | None | $741.31 | $1,023.29 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,148.15 Typical High $2,818.38 | Facility | None | $724.44 | $1,148.15 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,412.54 | Professional | None | $912.01 | $1,000.00 | $1,412.54 |
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 $645.65 Median $933.25 Typical High $1,819.70 | Professional | None | $645.65 | $933.25 | $1,819.70 |
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 $331.13 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $562.34 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $4,265.80 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $4,265.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,412.54 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,412.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,513.56 Typical High $3,467.37 | Professional | 50 · Both sides | $1,412.54 | $1,513.56 | $3,467.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $501.19 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $467.74 | $501.19 | $1,174.90 |
Where North Carolina sits
The same service costs 3.7 times more in Connecticut than in Arkansas. 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
CT $7,673AR $2,094
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.