How much rates vary
Facilitymedian $1,820 · 10th to 90th $550 to $4,898Professionalmedian $759 · 10th to 90th $417 to $1,259
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 $354.81 Median $457.09 Typical High $7,585.78 | Facility | None | $354.81 | $457.09 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $537.03 | Professional | None | $354.81 | $457.09 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,348.96 | Professional | None | $501.19 | $794.33 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,951.21 | Facility | None | $602.56 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,023.29 | Professional | None | $416.87 | $512.86 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,122.02 | Professional | None | $691.83 | $691.83 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,949.84 | Facility | None | $512.86 | $977.24 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $758.58 | Professional | None | $363.08 | $602.56 | $758.58 |
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 $346.74 Median $489.78 Typical High $1,047.13 | Professional | None | $346.74 | $489.78 | $1,047.13 |
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 $177.83 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $177.83 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $269.15 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $251.19 | $323.59 | $338.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $549.54 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $263.03 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $302.00 Typical High $549.54 | Professional | 51 · Multiple procedures | $181.97 | $302.00 | $549.54 |
Where North Carolina sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 9th of 51
$759
AK $1,778TX $295
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.