How much rates vary
Facilitymedian $1,514 · 10th to 90th $537 to $4,169Professionalmedian $933 · 10th to 90th $661 to $1,698
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 $660.69 Median $1,047.13 Typical High $8,317.64 | Facility | None | $660.69 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,148.15 | Professional | None | $645.65 | $660.69 | $1,148.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $3,715.35 | Facility | None | $933.25 | $1,479.11 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $812.83 | $1,122.02 | $1,778.28 |
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 $741.31 Median $776.25 Typical High $1,479.11 | Professional | None | $741.31 | $776.25 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,096.48 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $2,454.71 | Facility | None | $602.56 | $812.83 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,096.48 | Professional | None | $630.96 | $741.31 | $1,096.48 |
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 $524.81 Median $724.44 Typical High $1,621.81 | Professional | None | $524.81 | $724.44 | $1,621.81 |
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 $331.13 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $501.19 |
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 51 · Multiple procedures Typical Low $316.23 Median $371.54 Typical High $776.25 | Professional | 51 · Multiple procedures | $316.23 | $371.54 | $776.25 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska 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
AK $6,645WV $1,559
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.