How much rates vary
Facilitymedian $2,818 · 10th to 90th $776 to $9,120Professionalmedian $977 · 10th to 90th $724 to $2,089
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 $724.44 Median $1,288.25 Typical High $8,317.64 | Facility | None | $724.44 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $10,232.93 | Facility | None | $2,570.40 | $4,073.80 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,089.30 | Professional | None | $794.33 | $1,202.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $3,890.45 | Facility | None | $602.56 | $2,344.23 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,737.80 | Professional | None | $758.58 | $794.33 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,122.02 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $3,311.31 | Facility | None | $1,230.27 | $2,454.71 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,202.26 | Professional | None | $812.83 | $870.96 | $1,202.26 |
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 $602.56 Median $776.25 Typical High $1,778.28 | Professional | None | $602.56 | $776.25 | $1,778.28 |
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 $354.81 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $575.44 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $3,162.28 Median $4,897.79 Typical High $5,011.87 | Facility | 50 · Both sides | $3,162.28 | $4,897.79 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,659.59 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $1,047.13 | $1,659.59 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,288.25 Typical High $2,951.21 | Professional | 50 · Both sides | $1,230.27 | $1,288.25 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $436.52 Typical High $977.24 | Professional | 51 · Multiple procedures | $407.38 | $436.52 | $977.24 |
Where North Carolina sits
The same service costs 7.8 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· 22nd of 51
$1,047
AK $3,020TX $389
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.