How much rates vary
Facilitymedian $2,692 · 10th to 90th $692 to $8,710Professionalmedian $776 · 10th to 90th $537 to $1,549
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 $676.08 Typical High $7,943.28 | Facility | None | $562.34 | $676.08 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $912.01 | Professional | None | $562.34 | $562.34 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $954.99 | Professional | None | $288.40 | $489.78 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $5,128.61 | Facility | None | $1,995.26 | $3,235.94 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,584.89 | Professional | None | $724.44 | $912.01 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,348.96 | Professional | None | $478.63 | $562.34 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,348.96 | Professional | None | $724.44 | $724.44 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $4,265.80 | Facility | None | $707.95 | $1,778.28 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $954.99 | Professional | None | $602.56 | $676.08 | $954.99 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,412.54 | Professional | None | $467.74 | $575.44 | $1,412.54 |
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 $281.84 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $457.09 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $954.99 Typical High $2,137.96 | Facility | 51 · Multiple procedures | $363.08 | $954.99 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $363.08 Typical High $691.83 | Professional | 51 · Multiple procedures | $288.40 | $363.08 | $691.83 |
Where North Carolina sits
The same service costs 4.7 times more in Oklahoma than in Montana. 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
OK $8,820MT $1,888
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.