How much rates vary
Facilitymedian $162 · 10th to 90th $81 to $832Professionalmedian $380 · 10th to 90th $257 to $741
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 $257.04 Median $288.40 Typical High $7,413.10 | Facility | None | $257.04 | $288.40 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $426.58 | Professional | None | $257.04 | $288.40 | $426.58 |
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 $309.03 Median $446.68 Typical High $776.25 | Professional | None | $309.03 | $446.68 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $204.17 Typical High $331.13 | Facility | None | $56.23 | $204.17 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $645.65 | Professional | None | $229.09 | $275.42 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $676.08 | Professional | None | $398.11 | $398.11 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $407.38 | Facility | None | $104.71 | $128.82 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $446.68 | Professional | None | $281.84 | $309.03 | $446.68 |
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 $218.78 Median $275.42 Typical High $660.69 | Professional | None | $218.78 | $275.42 | $660.69 |
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 $125.89 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $125.89 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $208.93 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $190.55 Typical High $467.74 | Facility | 50 · Both sides | $123.03 | $190.55 | $467.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $154.88 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $501.19 Typical High $1,071.52 | Professional | 50 · Both sides | $416.87 | $501.19 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $169.82 Typical High $354.81 | Professional | 51 · Multiple procedures | $138.04 | $169.82 | $354.81 |
Where North Carolina sits
The same service costs 5.4 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· 17th of 51
$380
AK $1,096TX $204
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.