How much rates vary
Facilitymedian $1,622 · 10th to 90th $525 to $5,129Professionalmedian $676 · 10th to 90th $417 to $1,318
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 $380.19 Median $524.81 Typical High $7,585.78 | Facility | None | $380.19 | $524.81 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $724.44 | Professional | None | $380.19 | $524.81 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $891.25 | Professional | None | $537.03 | $537.03 | $891.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,737.80 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,479.11 | Professional | None | $524.81 | $794.33 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,454.71 | Facility | None | $602.56 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $1,122.02 | Professional | None | $416.87 | $562.34 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,258.93 | Professional | None | $794.33 | $794.33 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $2,570.40 | Facility | None | $512.86 | $831.76 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,318.26 | Professional | None | $501.19 | $630.96 | $1,318.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $1,071.52 | Professional | None | $363.08 | $524.81 | $1,071.52 |
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 $190.55 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $190.55 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $288.40 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $57.54 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $269.15 | $346.74 | $380.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,412.54 Typical High $4,365.16 | Facility | 50 · Both sides | $776.25 | $1,412.54 | $4,365.16 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $467.74 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $257.04 | $467.74 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $954.99 Typical High $1,995.26 | Professional | 50 · Both sides | $741.31 | $954.99 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $316.23 Typical High $660.69 | Professional | 51 · Multiple procedures | $251.19 | $316.23 | $660.69 |
Where North Carolina sits
The same service costs 4.7 times more in Colorado than in Montana. 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 $6,464MT $1,390
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.