How much rates vary
Facilitymedian $347 · 10th to 90th $209 to $2,239Professionalmedian $309 · 10th to 90th $178 to $631
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 $158.49 Median $257.04 Typical High $7,413.10 | Facility | None | $158.49 | $257.04 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $346.74 | Professional | None | $158.49 | $257.04 | $346.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $331.13 | Facility | None | $165.96 | $245.47 | $331.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $676.08 | Professional | None | $234.42 | $354.81 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $630.96 | Facility | None | $218.78 | $338.84 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $501.19 | Professional | None | $173.78 | $239.88 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $616.60 | Professional | None | $323.59 | $323.59 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $478.63 | Facility | None | $199.53 | $309.03 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $416.87 | Professional | None | $245.47 | $302.00 | $416.87 |
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 $151.36 Median $245.47 Typical High $512.86 | Professional | None | $151.36 | $245.47 | $512.86 |
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 $79.43 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $79.43 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $31.62 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $190.55 | Professional | 54 · Surgery only | $120.23 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $165.96 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $112.20 | $165.96 | $177.83 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $302.00 Median $467.74 Typical High $707.95 | Facility | 50 · Both sides | $302.00 | $467.74 | $707.95 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $100.00 Median $154.88 Typical High $239.88 | Facility | 51 · Multiple procedures | $100.00 | $154.88 | $239.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $457.09 Typical High $912.01 | Professional | 50 · Both sides | $363.08 | $457.09 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $151.36 Typical High $302.00 | Professional | 51 · Multiple procedures | $120.23 | $151.36 | $302.00 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 14th of 51
$309
AK $692UT $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.