How much rates vary
Facilitymedian $2,188 · 10th to 90th $603 to $6,918Professionalmedian $631 · 10th to 90th $447 to $1,230
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 $407.38 Median $1,047.13 Typical High $8,317.64 | Facility | None | $407.38 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $758.58 | Professional | None | $407.38 | $407.38 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $524.81 | Professional | None | $371.54 | $371.54 | $524.81 |
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 $446.68 Median $741.31 Typical High $1,230.27 | Professional | None | $446.68 | $741.31 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $1,047.13 | Professional | None | $489.78 | $501.19 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | None | $741.31 | $741.31 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $2,398.83 | Facility | None | $575.44 | $1,412.54 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $691.83 | Professional | None | $501.19 | $588.84 | $691.83 |
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 $354.81 Median $478.63 Typical High $1,047.13 | Professional | None | $354.81 | $478.63 | $1,047.13 |
8 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 $204.17 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $288.40 Typical High $512.86 | Professional | 51 · Multiple procedures | $263.03 | $288.40 | $512.86 |
Where North Carolina sits
The same service costs 5.1 times more in Wisconsin 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
WI $7,097MT $1,384
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.