How much rates vary
Facilitymedian $1,122 · 10th to 90th $513 to $2,754Professionalmedian $631 · 10th to 90th $447 to $1,230
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 $436.52 Median $1,000.00 Typical High $7,943.28 | Facility | None | $436.52 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $741.31 | Professional | None | $436.52 | $436.52 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,778.28 | Facility | None | $691.83 | $1,122.02 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,258.93 | Professional | None | $575.44 | $794.33 | $1,258.93 |
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 $478.63 Median $489.78 Typical High $1,071.52 | Professional | None | $478.63 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | None | $707.95 | $707.95 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,905.46 | Facility | None | $512.86 | $933.25 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $741.31 | Professional | None | $467.74 | $524.81 | $741.31 |
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 $371.54 Median $478.63 Typical High $1,096.48 | Professional | None | $371.54 | $478.63 | $1,096.48 |
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 $218.78 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $346.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $489.78 Typical High $933.25 | Facility | 51 · Multiple procedures | $257.04 | $489.78 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $263.03 Typical High $537.03 | Professional | 51 · Multiple procedures | $234.42 | $263.03 | $537.03 |
Where North Carolina sits
The same service costs 3.9 times more in Colorado than in Maryland. 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 $4,996MD $1,270
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.