How much rates vary
Facilitymedian $741 · 10th to 90th $363 to $2,042Professionalmedian $1,023 · 10th to 90th $708 to $1,995
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 $691.83 Median $1,148.15 Typical High $7,943.28 | Facility | None | $691.83 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $891.25 | Facility | None | $446.68 | $645.65 | $891.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,995.26 | Professional | None | $870.96 | $1,174.90 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,698.24 | Professional | None | $741.31 | $776.25 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,148.15 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $1,479.11 | Facility | None | $380.19 | $707.95 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,148.15 | Professional | None | $676.08 | $831.76 | $1,148.15 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,737.80 | Professional | None | $588.84 | $758.58 | $1,737.80 |
10 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 $346.74 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $549.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $537.03 Median $1,000.00 Typical High $2,187.76 | Facility | 50 · Both sides | $537.03 | $1,000.00 | $2,187.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $177.83 Median $331.13 Typical High $724.44 | Facility | 51 · Multiple procedures | $177.83 | $331.13 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,258.93 Typical High $2,511.89 | Professional | 50 · Both sides | $1,000.00 | $1,258.93 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $416.87 Typical High $831.76 | Professional | 51 · Multiple procedures | $338.84 | $416.87 | $831.76 |
Where North Carolina sits
The same service costs 3.6 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 $4,868DE $1,354
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.