How much rates vary
Facilitymedian $2,399 · 10th to 90th $646 to $6,457Professionalmedian $851 · 10th to 90th $589 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 $575.44 Median $1,148.15 Typical High $7,943.28 | Facility | None | $575.44 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | None | $575.44 | $575.44 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,698.24 | Professional | None | $588.84 | $1,000.00 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $4,168.69 | Facility | None | $602.56 | $2,818.38 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,445.44 | Professional | None | $645.65 | $660.69 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,000.00 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,412.54 Typical High $2,884.03 | Facility | None | $549.54 | $1,412.54 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,348.96 | Professional | None | $602.56 | $707.95 | $1,348.96 |
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 $489.78 Median $645.65 Typical High $1,445.44 | Professional | None | $489.78 | $645.65 | $1,445.44 |
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 $288.40 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $457.09 |
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 $891.25 Median $1,047.13 Typical High $2,089.30 | Professional | 50 · Both sides | $891.25 | $1,047.13 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $354.81 Typical High $707.95 | Professional | 51 · Multiple procedures | $302.00 | $354.81 | $707.95 |
Where North Carolina sits
The same service costs 7.9 times more in Alaska than in Texas. 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.
North Carolina· 21st of 51
$933
AK $2,455TX $309
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.