How much rates vary
Facilitymedian $2,455 · 10th to 90th $646 to $10,471Professionalmedian $832 · 10th to 90th $575 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 $537.03 Median $851.14 Typical High $7,585.78 | Facility | None | $537.03 | $851.14 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,000.00 | Professional | None | $537.03 | $537.03 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $3,311.31 | Facility | None | $1,318.26 | $2,089.30 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,621.81 | Professional | None | $630.96 | $1,023.29 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,244.36 Typical High $10,715.19 | Facility | None | $602.56 | $7,244.36 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,380.38 | Professional | None | $660.69 | $676.08 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,023.29 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $1,122.02 Typical High $7,079.46 | Facility | None | $537.03 | $1,122.02 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $912.01 | Professional | None | $645.65 | $794.33 | $912.01 |
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 $467.74 Median $645.65 Typical High $1,348.96 | Professional | None | $467.74 | $645.65 | $1,348.96 |
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 $269.15 Median $269.15 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $2,137.96 Typical High $15,488.17 | Facility | 50 · Both sides | $776.25 | $2,137.96 | $15,488.17 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $707.95 Typical High $5,128.61 | Facility | 51 · Multiple procedures | $263.03 | $707.95 | $5,128.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,348.96 Typical High $1,995.26 | Professional | 50 · Both sides | $1,071.52 | $1,348.96 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $446.68 Typical High $660.69 | Professional | 51 · Multiple procedures | $354.81 | $446.68 | $660.69 |
Where North Carolina sits
The same service costs 6.2 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 $10,992MT $1,762
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.