How much rates vary
Facilitymedian $2,138 · 10th to 90th $646 to $6,918Professionalmedian $977 · 10th to 90th $676 to $1,905
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 $645.65 Median $1,000.00 Typical High $7,943.28 | Facility | None | $645.65 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,148.15 | Professional | None | $645.65 | $645.65 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $645.65 | Professional | None | $416.87 | $416.87 | $645.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,691.53 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,905.46 | Professional | None | $870.96 | $1,202.26 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,235.94 | Facility | None | $602.56 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,621.81 | Professional | None | $794.33 | $812.83 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,202.26 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,412.54 Typical High $3,388.44 | Facility | None | $549.54 | $1,412.54 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,258.93 | Professional | None | $794.33 | $954.99 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,584.89 | Professional | None | $562.34 | $776.25 | $1,584.89 |
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 $323.59 Median $323.59 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $524.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $776.25 | $2,137.96 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $263.03 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,445.44 Typical High $2,344.23 | Professional | 50 · Both sides | $1,258.93 | $1,445.44 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $478.63 Typical High $776.25 | Professional | 51 · Multiple procedures | $426.58 | $478.63 | $776.25 |
Where North Carolina sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.