How much rates vary
Facilitymedian $3,548 · 10th to 90th $851 to $9,550Professionalmedian $1,122 · 10th to 90th $692 to $1,820
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 $1,288.25 Typical High $10,715.19 | Facility | None | $660.69 | $1,288.25 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $5,370.32 | Facility | None | $2,089.30 | $3,388.44 | $5,370.32 |
BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,905.46 | Professional | None | $831.76 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,709.64 | Facility | None | $602.56 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,621.81 | Professional | None | $741.31 | $758.58 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $5,248.07 Typical High $10,964.78 | Facility | None | $707.95 | $5,248.07 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,096.48 | Professional | None | $794.33 | $891.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,659.59 | Professional | None | $562.34 | $741.31 | $1,659.59 |
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 $331.13 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $524.81 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 50 · Both sides | $1,737.80 | $1,737.80 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,380.38 Typical High $2,398.83 | Professional | 50 · Both sides | $1,230.27 | $1,380.38 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $457.09 Typical High $794.33 | Professional | 51 · Multiple procedures | $407.38 | $457.09 | $794.33 |
Where North Carolina sits
The same service costs 7.4 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
$1,122
AK $2,754TX $372
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.