How much rates vary
Facilitymedian $302 · 10th to 90th $120 to $1,047Professionalmedian $427 · 10th to 90th $275 to $813
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 $288.40 Median $302.00 Typical High $7,413.10 | Facility | None | $288.40 | $302.00 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $426.58 | Professional | None | $288.40 | $302.00 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $537.03 | Facility | None | $269.15 | $398.11 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $831.76 | Professional | None | $346.74 | $489.78 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,318.26 | Facility | None | $162.18 | $263.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $691.83 | Professional | None | $229.09 | $295.12 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $707.95 | Professional | None | $371.54 | $371.54 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $363.08 Typical High $537.03 | Facility | None | $181.97 | $363.08 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $512.86 | Professional | None | $295.12 | $354.81 | $512.86 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $724.44 | Professional | None | $239.88 | $309.03 | $724.44 |
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 $144.54 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $144.54 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $218.78 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $223.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $85.11 Median $173.78 Typical High $251.19 | Facility | 51 · Multiple procedures | $85.11 | $173.78 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $194.98 Typical High $371.54 | Professional | 51 · Multiple procedures | $147.91 | $194.98 | $371.54 |
Where North Carolina sits
The same service costs 5.5 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· 20th of 51
$417
AK $1,230TX $224
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.