How much rates vary
Facilitymedian $1,738 · 10th to 90th $457 to $5,129Professionalmedian $427 · 10th to 90th $288 to $794
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 $269.15 Median $870.96 Typical High $7,943.28 | Facility | None | $269.15 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $512.86 | Professional | None | $269.15 | $269.15 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,174.90 | $1,737.80 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $794.33 | Professional | None | $354.81 | $512.86 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,235.94 | Facility | None | $457.09 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $707.95 | Professional | None | $338.84 | $346.74 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | None | $524.81 | $524.81 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $2,570.40 | Facility | None | $371.54 | $954.99 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $1,096.48 | Professional | None | $331.13 | $371.54 | $1,096.48 |
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 $234.42 Median $323.59 Typical High $660.69 | Professional | None | $234.42 | $323.59 | $660.69 |
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 $134.90 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $218.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,445.44 Typical High $5,011.87 | Facility | 50 · Both sides | $562.34 | $1,445.44 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $478.63 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $186.21 | $478.63 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $562.34 Typical High $1,659.59 | Professional | 50 · Both sides | $537.03 | $562.34 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $186.21 Typical High $549.54 | Professional | 51 · Multiple procedures | $177.83 | $186.21 | $549.54 |
Where North Carolina sits
The same service costs 7.3 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 $6,269MT $863
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.