How much rates vary
Facilitymedian $776 · 10th to 90th $355 to $2,570Professionalmedian $603 · 10th to 90th $389 to $1,148
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 $398.11 Median $436.52 Typical High $5,495.41 | Facility | None | $398.11 | $436.52 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $691.83 | Professional | None | $398.11 | $426.58 | $691.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $1,202.26 | Professional | None | $389.05 | $724.44 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,737.80 | Facility | None | $457.09 | $1,318.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $977.24 | Professional | None | $407.38 | $446.68 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,023.29 | Professional | None | $660.69 | $660.69 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $549.54 Typical High $1,548.82 | Facility | None | $380.19 | $549.54 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $707.95 | Professional | None | $416.87 | $524.81 | $707.95 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,000.00 | Professional | None | $346.74 | $446.68 | $1,000.00 |
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 $199.53 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $316.23 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $794.33 Typical High $2,818.38 | Facility | 50 · Both sides | $562.34 | $794.33 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $269.15 Typical High $933.25 | Facility | 51 · Multiple procedures | $186.21 | $269.15 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $812.83 Typical High $1,584.89 | Professional | 50 · Both sides | $630.96 | $812.83 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $275.42 Typical High $537.03 | Professional | 51 · Multiple procedures | $208.93 | $275.42 | $537.03 |
Where North Carolina sits
The same service costs 4.7 times more in Colorado than in Delaware. 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 $4,364DE $926
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.