How much rates vary
Facilitymedian $209 · 10th to 90th $81 to $891Professionalmedian $447 · 10th to 90th $295 to $851
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 $316.23 Median $331.13 Typical High $5,248.07 | Facility | None | $316.23 | $331.13 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $524.81 | Professional | None | $316.23 | $331.13 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $549.54 | Professional | None | $173.78 | $380.19 | $549.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $912.01 | Professional | None | $354.81 | $512.86 | $912.01 |
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 $257.04 Median $302.00 Typical High $758.58 | Professional | None | $257.04 | $302.00 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $794.33 | Professional | None | $436.52 | $436.52 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $436.52 | Facility | None | $102.33 | $158.49 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $537.03 | Professional | None | $323.59 | $363.08 | $537.03 |
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 $251.19 Median $331.13 Typical High $812.83 | Professional | None | $251.19 | $331.13 | $812.83 |
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 $158.49 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $158.49 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $63.10 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $223.87 | $234.42 | $251.19 |
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 $489.78 Median $549.54 Typical High $1,258.93 | Professional | 50 · Both sides | $489.78 | $549.54 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $181.97 Typical High $416.87 | Professional | 51 · Multiple procedures | $162.18 | $181.97 | $416.87 |
Where North Carolina sits
The same service costs 5.6 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· 18th of 51
$447
AK $1,380TX $245
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.