How much rates vary
Facilitymedian $3,631 · 10th to 90th $832 to $9,772Professionalmedian $1,622 · 10th to 90th $832 to $2,239
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 $812.83 Median $1,288.25 Typical High $10,471.29 | Facility | None | $812.83 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,412.54 | Professional | None | $812.83 | $812.83 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,715.35 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,862.09 | $2,344.23 |
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 $912.01 Median $933.25 Typical High $1,995.26 | Professional | None | $912.01 | $933.25 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,412.54 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $5,248.07 | Facility | None | $741.31 | $2,137.96 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,318.26 | Professional | None | $912.01 | $1,047.13 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,995.26 | Professional | None | $691.83 | $891.25 | $1,995.26 |
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 $398.11 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $645.65 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $3,162.28 Typical High $10,964.78 | Facility | 50 · Both sides | $1,096.48 | $3,162.28 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,047.13 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $1,047.13 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,951.21 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $977.24 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $977.24 |
Where North Carolina sits
The same service costs 5.3 times more in Colorado 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
CO $14,031MT $2,637
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.