How much rates vary
Facilitymedian $1,514 · 10th to 90th $537 to $4,169Professionalmedian $955 · 10th to 90th $575 to $1,585
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 $562.34 Median $1,288.25 Typical High $8,317.64 | Facility | None | $562.34 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $724.44 | Professional | None | $562.34 | $562.34 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $4,073.80 | Facility | None | $933.25 | $1,288.25 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,584.89 | Professional | None | $724.44 | $954.99 | $1,584.89 |
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 $602.56 Median $630.96 Typical High $1,380.38 | Professional | None | $602.56 | $630.96 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,818.38 | Facility | None | $588.84 | $977.24 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $933.25 | Professional | None | $645.65 | $676.08 | $933.25 |
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 $467.74 Median $602.56 Typical High $1,380.38 | Professional | None | $467.74 | $602.56 | $1,380.38 |
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 $275.42 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $446.68 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $338.84 Typical High $676.08 | Professional | 51 · Multiple procedures | $323.59 | $338.84 | $676.08 |
Where North Carolina sits
The same service costs 4.7 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 $6,418DE $1,376
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.