How much rates vary
Facilitymedian $1,514 · 10th to 90th $513 to $4,169Professionalmedian $646 · 10th to 90th $468 to $1,259
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 $457.09 Median $1,288.25 Typical High $8,317.64 | Facility | None | $457.09 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | None | $457.09 | $457.09 | $602.56 |
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 $575.44 Median $776.25 Typical High $1,318.26 | Professional | None | $575.44 | $776.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $1,122.02 | Professional | None | $489.78 | $512.86 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,096.48 | Professional | None | $741.31 | $741.31 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $2,691.53 | Facility | None | $575.44 | $794.33 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $776.25 | Professional | None | $512.86 | $549.54 | $776.25 |
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 $389.05 Median $501.19 Typical High $1,148.15 | Professional | None | $389.05 | $501.19 | $1,148.15 |
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 $229.09 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $363.08 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,230.27 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $1,230.27 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $407.38 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $407.38 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $812.83 Typical High $1,778.28 | Professional | 50 · Both sides | $776.25 | $812.83 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $275.42 Typical High $588.84 | Professional | 51 · Multiple procedures | $257.04 | $275.42 | $588.84 |
Where North Carolina sits
The same service costs 5.1 times more in Colorado than in Delaware. 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 $6,284DE $1,221
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.