How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $6,918Professionalmedian $871 · 10th to 90th $562 to $1,585
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 $524.81 Median $707.95 Typical High $7,943.28 | Facility | None | $524.81 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $954.99 | Professional | None | $524.81 | $524.81 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,584.89 | Professional | None | $676.08 | $954.99 | $1,584.89 |
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 $630.96 Median $645.65 Typical High $1,348.96 | Professional | None | $630.96 | $645.65 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,230.27 | Professional | None | $954.99 | $954.99 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $3,311.31 | Facility | None | $588.84 | $1,412.54 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,096.48 | Professional | None | $645.65 | $758.58 | $1,096.48 |
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 $457.09 Median $616.60 Typical High $1,318.26 | Professional | None | $457.09 | $616.60 | $1,318.26 |
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 $263.03 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $426.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $5,011.87 |
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 50 · Both sides Typical Low $1,023.29 Median $1,230.27 Typical High $2,137.96 | Professional | 50 · Both sides | $1,023.29 | $1,230.27 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $416.87 Typical High $724.44 | Professional | 51 · Multiple procedures | $346.74 | $416.87 | $724.44 |
Where North Carolina sits
The same service costs 4.3 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 $7,406MT $1,722
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.