How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $2,455Professionalmedian $479 · 10th to 90th $174 to $977
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 $141.25 Median $346.74 Typical High $7,413.10 | Facility | None | $141.25 | $346.74 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $346.74 Typical High $524.81 | Professional | None | $141.25 | $346.74 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,819.70 | Facility | None | $933.25 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $218.78 Median $549.54 Typical High $1,071.52 | Professional | None | $218.78 | $549.54 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,479.11 | Facility | None | $457.09 | $1,202.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $436.52 Typical High $707.95 | Professional | None | $169.82 | $436.52 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | None | $758.58 | $758.58 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $1,479.11 | Facility | None | $346.74 | $602.56 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $575.44 | Professional | None | $281.84 | $457.09 | $575.44 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $138.04 Median $323.59 Typical High $676.08 | Professional | None | $138.04 | $323.59 | $676.08 |
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 $69.18 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $69.18 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $28.18 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $104.71 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $20.89 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.13 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $208.93 | $245.47 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $72.44 Median $147.91 Typical High $181.97 | Professional | 58 · Staged procedure | $72.44 | $147.91 | $181.97 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $346.74 Typical High $724.44 | Facility | 51 · Multiple procedures | $186.21 | $346.74 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $229.09 Typical High $426.58 | Professional | 51 · Multiple procedures | $141.25 | $229.09 | $426.58 |
Where North Carolina sits
The same service costs 4.0 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· 7th of 51
$490
AK $759KY $191
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.