How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $2,455Professionalmedian $380 · 10th to 90th $170 to $646
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 $151.36 Median $263.03 Typical High $5,495.41 | Facility | None | $151.36 | $263.03 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $331.13 | Professional | None | $151.36 | $263.03 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | None | $338.84 | $338.84 | $446.68 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $676.08 | Professional | None | $229.09 | $407.38 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,071.52 Typical High $1,778.28 | Facility | None | $416.87 | $1,071.52 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $501.19 | Professional | None | $169.82 | $251.19 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $645.65 | Professional | None | $346.74 | $346.74 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $1,071.52 Typical High $1,479.11 | Facility | None | $275.42 | $1,071.52 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $426.58 | Professional | None | $208.93 | $309.03 | $426.58 |
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 $141.25 Median $251.19 Typical High $512.86 | Professional | None | $141.25 | $251.19 | $512.86 |
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 $75.86 Median $120.23 Typical High $131.83 | Professional | 52 · Reduced service | $75.86 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $30.20 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $114.82 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.14 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $169.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $107.15 | $169.82 | $181.97 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $371.54 Median $537.03 Typical High $724.44 | Facility | 51 · Multiple procedures | $371.54 | $537.03 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $154.88 Typical High $331.13 | Professional | 51 · Multiple procedures | $104.71 | $154.88 | $331.13 |
Where North Carolina sits
The same service costs 4.5 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· 8th of 51
$380
AK $759KY $170
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.