How much rates vary
Facilitymedian $191 · 10th to 90th $81 to $832Professionalmedian $417 · 10th to 90th $282 to $832
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 $281.84 Median $302.00 Typical High $5,248.07 | Facility | None | $281.84 | $302.00 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $467.74 | Professional | None | $281.84 | $302.00 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $338.84 Median $489.78 Typical High $831.76 | Professional | None | $338.84 | $489.78 | $831.76 |
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 $263.03 Median $309.03 Typical High $707.95 | Professional | None | $263.03 | $309.03 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $724.44 | Professional | None | $446.68 | $446.68 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $436.52 | Facility | None | $87.10 | $128.82 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $501.19 | Professional | None | $295.12 | $354.81 | $501.19 |
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 $239.88 Median $309.03 Typical High $707.95 | Professional | None | $239.88 | $309.03 | $707.95 |
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 $141.25 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $208.93 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $223.87 |
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 $446.68 Median $537.03 Typical High $1,148.15 | Professional | 50 · Both sides | $446.68 | $537.03 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $177.83 Typical High $380.19 | Professional | 51 · Multiple procedures | $147.91 | $177.83 | $380.19 |
Where North Carolina sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$407
AK $1,202UT $219
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.