How much rates vary
Facilitymedian $1,023 · 10th to 90th $501 to $2,344Professionalmedian $676 · 10th to 90th $380 to $1,380
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 $323.59 Median $537.03 Typical High $5,248.07 | Facility | None | $323.59 | $537.03 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $776.25 | Professional | None | $323.59 | $537.03 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $549.54 | Professional | None | $501.19 | $524.81 | $549.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,479.11 | Professional | None | $489.78 | $758.58 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $1,047.13 | Professional | None | $389.05 | $676.08 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,023.29 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,479.11 | Facility | None | $512.86 | $707.95 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,148.15 | Professional | None | $512.86 | $676.08 | $1,148.15 |
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 $309.03 Median $512.86 Typical High $1,071.52 | Professional | None | $309.03 | $512.86 | $1,071.52 |
8 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 $162.18 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $162.18 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $64.57 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $239.88 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $48.98 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $223.87 | $346.74 | $380.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $426.58 Typical High $724.44 | Facility | 51 · Multiple procedures | $263.03 | $426.58 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $338.84 Typical High $645.65 | Professional | 51 · Multiple procedures | $257.04 | $338.84 | $645.65 |
Where North Carolina sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.