How much rates vary
Facilitymedian $1,096 · 10th to 90th $501 to $3,388Professionalmedian $427 · 10th to 90th $316 to $912
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 $1,148.15 Typical High $7,943.28 | Facility | None | $316.23 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | None | $316.23 | $316.23 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,715.35 | Facility | None | $933.25 | $1,445.44 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $912.01 | Professional | None | $371.54 | $512.86 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,819.70 | Facility | None | $602.56 | $1,445.44 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $741.31 | Professional | None | $316.23 | $338.84 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $758.58 | Professional | None | $467.74 | $467.74 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $1,819.70 | Facility | None | $512.86 | $724.44 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $537.03 | Professional | None | $338.84 | $363.08 | $537.03 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $794.33 | Professional | None | $269.15 | $338.84 | $794.33 |
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 $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $251.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,258.93 Typical High $2,818.38 | Facility | 50 · Both sides | $776.25 | $1,258.93 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $426.58 Typical High $933.25 | Facility | 51 · Multiple procedures | $263.03 | $426.58 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $537.03 Typical High $1,202.26 | Professional | 50 · Both sides | $512.86 | $537.03 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $181.97 Typical High $398.11 | Professional | 51 · Multiple procedures | $169.82 | $181.97 | $398.11 |
Where North Carolina sits
The same service costs 4.6 times more in Colorado than in Montana. 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
CO $4,822MT $1,050
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.