How much rates vary
Facilitymedian $2,630 · 10th to 90th $794 to $8,318Professionalmedian $1,259 · 10th to 90th $708 to $1,862
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 $645.65 Median $1,288.25 Typical High $10,471.29 | Facility | None | $645.65 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,174.90 | Professional | None | $645.65 | $645.65 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,949.84 | Professional | None | $870.96 | $1,258.93 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,413.10 | Facility | None | $794.33 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,621.81 | Professional | None | $794.33 | $812.83 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,202.26 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $4,677.35 | Facility | None | $724.44 | $1,412.54 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,230.27 | Professional | None | $741.31 | $831.76 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,621.81 | Professional | None | $562.34 | $776.25 | $1,621.81 |
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 $323.59 Median $323.59 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $524.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,137.96 Typical High $7,413.10 | Facility | 50 · Both sides | $1,096.48 | $2,137.96 | $7,413.10 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $707.95 Typical High $2,511.89 | Facility | 51 · Multiple procedures | $363.08 | $707.95 | $2,511.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,230.27 Typical High $2,454.71 | Professional | 50 · Both sides | $1,122.02 | $1,230.27 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $416.87 Typical High $831.76 | Professional | 51 · Multiple procedures | $371.54 | $416.87 | $831.76 |
Where North Carolina sits
The same service costs 4.8 times more in Alaska than in Montana. 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
AK $10,454MT $2,169
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.