How much rates vary
Facilitymedian $229 · 10th to 90th $100 to $955Professionalmedian $389 · 10th to 90th $257 to $741
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 $257.04 Median $269.15 Typical High $7,413.10 | Facility | None | $257.04 | $269.15 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $436.52 | Professional | None | $257.04 | $269.15 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $323.59 | Facility | None | $81.28 | $125.89 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $758.58 | Professional | None | $323.59 | $446.68 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $524.81 | Facility | None | $158.49 | $257.04 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $616.60 | Professional | None | $245.47 | $269.15 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $630.96 | Professional | None | $389.05 | $389.05 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $426.58 | Facility | None | $87.10 | $128.82 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $457.09 | Professional | None | $275.42 | $316.23 | $457.09 |
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 $213.80 Median $275.42 Typical High $645.65 | Professional | None | $213.80 | $275.42 | $645.65 |
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 $128.82 Median $131.83 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $213.80 | Professional | 54 · Surgery only | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $42.66 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $199.53 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $190.55 Typical High $467.74 | Facility | 50 · Both sides | $123.03 | $190.55 | $467.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $154.88 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $478.63 Typical High $1,000.00 | Professional | 50 · Both sides | $407.38 | $478.63 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $158.49 Typical High $331.13 | Professional | 51 · Multiple procedures | $134.90 | $158.49 | $331.13 |
Where North Carolina sits
The same service costs 5.9 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· 15th of 51
$389
AK $1,096TX $186
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.