How much rates vary
Facilitymedian $1,122 · 10th to 90th $513 to $3,467Professionalmedian $1,380 · 10th to 90th $776 to $2,089
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 $741.31 Median $1,000.00 Typical High $7,585.78 | Facility | None | $741.31 | $1,000.00 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Professional | None | $741.31 | $741.31 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,380.38 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,819.70 | Facility | None | $602.56 | $1,445.44 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,862.09 | Professional | None | $870.96 | $870.96 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,318.26 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $741.31 Typical High $1,905.46 | Facility | None | $512.86 | $741.31 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,230.27 | Professional | None | $707.95 | $977.24 | $1,230.27 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,819.70 | Professional | None | $645.65 | $851.14 | $1,819.70 |
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 $371.54 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $602.56 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,047.13 Typical High $2,818.38 | Facility | 50 · Both sides | $776.25 | $1,047.13 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $346.74 Typical High $933.25 | Facility | 51 · Multiple procedures | $257.04 | $346.74 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,584.89 Typical High $2,691.53 | Professional | 50 · Both sides | $1,071.52 | $1,584.89 | $2,691.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $524.81 Typical High $891.25 | Professional | 51 · Multiple procedures | $354.81 | $524.81 | $891.25 |
Where North Carolina sits
The same service costs 3.6 times more in Alaska than in Alabama. 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
AK $5,545AL $1,558
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.