How much rates vary
Facilitymedian $263 · 10th to 90th $100 to $1,175Professionalmedian $468 · 10th to 90th $295 to $871
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 $295.12 Median $323.59 Typical High $7,413.10 | Facility | None | $295.12 | $323.59 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $501.19 | Professional | None | $295.12 | $323.59 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $323.59 | Facility | None | $81.28 | $125.89 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $891.25 | Professional | None | $371.54 | $524.81 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,318.26 | Facility | None | $162.18 | $263.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $741.31 | Professional | None | $288.40 | $331.13 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $758.58 | Professional | None | $478.63 | $478.63 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $371.54 Typical High $537.03 | Facility | None | $87.10 | $371.54 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $562.34 | Professional | None | $316.23 | $380.19 | $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 $257.04 Median $323.59 Typical High $758.58 | Professional | None | $257.04 | $323.59 | $758.58 |
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 $147.91 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $234.42 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $467.74 Typical High $758.58 | Facility | 50 · Both sides | $123.03 | $467.74 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $154.88 Typical High $251.19 | Facility | 51 · Multiple procedures | $40.74 | $154.88 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $588.84 Typical High $1,202.26 | Professional | 50 · Both sides | $478.63 | $588.84 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $194.98 Typical High $398.11 | Professional | 51 · Multiple procedures | $158.49 | $194.98 | $398.11 |
Where North Carolina sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 14th of 51
$468
AK $1,259UT $219
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.