How much rates vary
Facilitymedian $224 · 10th to 90th $98 to $1,047Professionalmedian $692 · 10th to 90th $479 to $1,349
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 $446.68 Median $489.78 Typical High $5,495.41 | Facility | None | $446.68 | $489.78 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $776.25 | Professional | None | $446.68 | $489.78 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Facility | None | $79.43 | $117.49 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,380.38 | Professional | None | $537.03 | $812.83 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,318.26 | Facility | None | $162.18 | $263.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $1,122.02 | Professional | None | $478.63 | $512.86 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | None | $758.58 | $758.58 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $380.19 Typical High $724.44 | Facility | None | $87.10 | $380.19 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $831.76 | Professional | None | $478.63 | $575.44 | $831.76 |
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 $389.05 Median $512.86 Typical High $1,148.15 | Professional | None | $389.05 | $512.86 | $1,148.15 |
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 $223.87 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $363.08 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $467.74 Typical High $758.58 | Facility | 50 · Both sides | $123.03 | $467.74 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $154.88 Typical High $251.19 | Facility | 51 · Multiple procedures | $40.74 | $154.88 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,819.70 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $288.40 Typical High $602.56 | Professional | 51 · Multiple procedures | $234.42 | $288.40 | $602.56 |
Where North Carolina sits
The same service costs 4.7 times more in New York 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
NY $3,038FL $649
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.