How much rates vary
Facilitymedian $2,089 · 10th to 90th $589 to $5,754Professionalmedian $851 · 10th to 90th $468 to $1,318
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 $426.58 Median $588.84 Typical High $7,943.28 | Facility | None | $426.58 | $588.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $891.25 | Professional | None | $426.58 | $426.58 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $3,311.31 | Facility | None | $1,318.26 | $2,089.30 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,318.26 | Professional | None | $602.56 | $933.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,202.26 | Professional | None | $537.03 | $891.25 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $2,691.53 | Facility | None | $575.44 | $1,412.54 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,148.15 | Professional | None | $457.09 | $616.60 | $1,148.15 |
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 $363.08 Median $562.34 Typical High $1,071.52 | Professional | None | $363.08 | $562.34 | $1,071.52 |
8 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 $213.80 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $346.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $302.00 Typical High $588.84 | Professional | 51 · Multiple procedures | $229.09 | $302.00 | $588.84 |
Where North Carolina sits
The same service costs 5.0 times more in Wisconsin 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
WI $7,200MT $1,432
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.