How much rates vary
Facilitymedian $1,349 · 10th to 90th $537 to $3,388Professionalmedian $871 · 10th to 90th $550 to $1,549
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 $537.03 Median $1,000.00 Typical High $7,943.28 | Facility | None | $537.03 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | None | $954.99 | $954.99 | $1,071.52 |
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 $691.83 Median $933.25 Typical High $1,584.89 | Professional | None | $691.83 | $933.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,454.71 | Facility | None | $602.56 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,318.26 | Professional | None | $602.56 | $616.60 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | None | $912.01 | $912.01 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $2,238.72 | Facility | None | $524.81 | $794.33 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $1,047.13 | Professional | None | $602.56 | $660.69 | $1,047.13 |
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 $457.09 Median $588.84 Typical High $1,318.26 | Professional | None | $457.09 | $588.84 | $1,318.26 |
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 $269.15 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $426.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,202.26 Typical High $4,365.16 | Facility | 50 · Both sides | $776.25 | $1,202.26 | $4,365.16 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $398.11 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $257.04 | $398.11 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,000.00 Typical High $1,949.84 | Professional | 50 · Both sides | $891.25 | $1,000.00 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $338.84 Typical High $645.65 | Professional | 51 · Multiple procedures | $302.00 | $338.84 | $645.65 |
Where North Carolina sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,382DE $1,376
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.