How much rates vary
Facilitymedian $676 · 10th to 90th $302 to $1,950Professionalmedian $331 · 10th to 90th $186 to $661
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 $169.82 Median $269.15 Typical High $7,413.10 | Facility | None | $169.82 | $269.15 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $380.19 | Professional | None | $169.82 | $269.15 | $380.19 |
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 $186.21 Median $389.05 Typical High $707.95 | Professional | None | $186.21 | $389.05 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,479.11 | Facility | None | $457.09 | $1,202.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $537.03 | Professional | None | $186.21 | $257.04 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $645.65 | Professional | None | $363.08 | $363.08 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $1,071.52 | Facility | None | $269.15 | $416.87 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $446.68 | Professional | None | $257.04 | $316.23 | $446.68 |
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 $165.96 Median $257.04 Typical High $537.03 | Professional | None | $165.96 | $257.04 | $537.03 |
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 $85.11 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $199.53 | Professional | 54 · Surgery only | $125.89 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $25.12 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $186.21 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $537.03 Median $724.44 Typical High $2,187.76 | Facility | 50 · Both sides | $537.03 | $724.44 | $2,187.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $177.83 Median $239.88 Typical High $724.44 | Facility | 51 · Multiple procedures | $177.83 | $239.88 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $478.63 Typical High $954.99 | Professional | 50 · Both sides | $389.05 | $478.63 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $158.49 Typical High $316.23 | Professional | 51 · Multiple procedures | $128.82 | $158.49 | $316.23 |
Where North Carolina sits
The same service costs 4.1 times more in Alaska than in Texas. 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.
North Carolina· 12th of 51
$347
AK $851TX $209
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.