How much rates vary
Facilitymedian $1,047 · 10th to 90th $501 to $2,455Professionalmedian $437 · 10th to 90th $263 to $1,096
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 $269.15 Median $512.86 Typical High $7,585.78 | Facility | None | $269.15 | $512.86 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $630.96 | Professional | None | $323.59 | $436.52 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $288.40 Median $436.52 Typical High $1,148.15 | Professional | None | $288.40 | $436.52 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $977.24 | Professional | None | $194.98 | $275.42 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,230.27 | Professional | None | $436.52 | $436.52 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $1,148.15 | Facility | None | $446.68 | $707.95 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $691.83 | Professional | None | $371.54 | $478.63 | $691.83 |
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 $234.42 Median $416.87 Typical High $954.99 | Professional | None | $234.42 | $416.87 | $954.99 |
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 $162.18 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $239.88 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $223.87 | $331.13 | $354.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,202.26 Typical High $2,187.76 | Facility | 50 · Both sides | $776.25 | $1,202.26 | $2,187.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $398.11 Typical High $724.44 | Facility | 51 · Multiple procedures | $263.03 | $398.11 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $724.44 Typical High $1,778.28 | Professional | 50 · Both sides | $524.81 | $724.44 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $239.88 Typical High $602.56 | Professional | 51 · Multiple procedures | $173.78 | $239.88 | $602.56 |
Where North Carolina sits
The same service costs 4.5 times more in Colorado than in Maryland. 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
CO $4,866MD $1,088
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.