How much rates vary
Facilitymedian $603 · 10th to 90th $316 to $2,239Professionalmedian $661 · 10th to 90th $417 to $1,175
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 $398.11 Median $426.58 Typical High $7,585.78 | Facility | None | $398.11 | $426.58 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $676.08 | Professional | None | $398.11 | $426.58 | $676.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $537.03 | Facility | None | $269.15 | $398.11 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,202.26 | Professional | None | $512.86 | $741.31 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,819.70 | Facility | None | $602.56 | $1,445.44 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $977.24 | Professional | None | $416.87 | $446.68 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,000.00 | Professional | None | $645.65 | $645.65 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $645.65 Typical High $1,659.59 | Facility | None | $263.03 | $645.65 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $724.44 | Professional | None | $416.87 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $1,000.00 | Professional | None | $338.84 | $446.68 | $1,000.00 |
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 $194.98 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $316.23 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $371.54 Median $1,000.00 Typical High $2,818.38 | Facility | 50 · Both sides | $371.54 | $1,000.00 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $123.03 Median $331.13 Typical High $933.25 | Facility | 51 · Multiple procedures | $123.03 | $331.13 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $741.31 Typical High $1,584.89 | Professional | 50 · Both sides | $630.96 | $741.31 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $245.47 Typical High $537.03 | Professional | 51 · Multiple procedures | $208.93 | $245.47 | $537.03 |
Where North Carolina sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.