How much rates vary
Facilitymedian $186 · 10th to 90th $83 to $537Professionalmedian $407 · 10th to 90th $257 to $759
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 $257.04 Median $281.84 Typical High $467.74 | Facility | None | $257.04 | $281.84 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $436.52 | Professional | None | $257.04 | $281.84 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Facility | None | $79.43 | $117.49 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Professional | None | $331.13 | $457.09 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $204.17 Typical High $331.13 | Facility | None | $56.23 | $204.17 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $660.69 | Professional | None | $245.47 | $288.40 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $676.08 | Professional | None | $407.38 | $407.38 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $436.52 | Facility | None | $87.10 | $128.82 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $562.34 | Professional | None | $275.42 | $346.74 | $562.34 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $660.69 | Professional | None | $218.78 | $281.84 | $660.69 |
9 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 $128.82 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $208.93 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $263.03 | Professional | 54 · Surgery only | $218.78 | $234.42 | $263.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $154.88 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $154.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $194.98 Typical High $354.81 | Professional | 51 · Multiple procedures | $138.04 | $194.98 | $354.81 |
Where North Carolina sits
The same service costs 6.4 times more in Colorado than in Florida. 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 $2,602FL $408
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.