How much rates vary
Facilitymedian $224 · 10th to 90th $93 to $1,096Professionalmedian $457 · 10th to 90th $282 to $851
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 $281.84 Median $309.03 Typical High $7,413.10 | Facility | None | $281.84 | $309.03 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $512.86 | Professional | None | $281.84 | $309.03 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $616.60 | Professional | None | $302.00 | $616.60 | $616.60 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Facility | None | $79.43 | $117.49 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $870.96 | Professional | None | $363.08 | $512.86 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,318.26 | Facility | None | $162.18 | $263.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $707.95 | Professional | None | $281.84 | $331.13 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $741.31 | Professional | None | $478.63 | $478.63 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $371.54 Typical High $537.03 | Facility | None | $87.10 | $371.54 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $524.81 | Professional | None | $281.84 | $363.08 | $524.81 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $724.44 | Professional | None | $245.47 | $316.23 | $724.44 |
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 $141.25 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $234.42 Typical High $245.47 | Professional | 54 · Surgery only | $213.80 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $199.53 | $218.78 | $229.09 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $467.74 Typical High $758.58 | Facility | 50 · Both sides | $123.03 | $467.74 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $154.88 Typical High $251.19 | Facility | 51 · Multiple procedures | $40.74 | $154.88 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $549.54 Typical High $1,148.15 | Professional | 50 · Both sides | $416.87 | $549.54 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $181.97 Typical High $380.19 | Professional | 51 · Multiple procedures | $141.25 | $181.97 | $380.19 |
Where North Carolina sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 14th of 51
$457
AK $1,202UT $219
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.