How much rates vary
Facilitymedian $2,951 · 10th to 90th $661 to $10,471Professionalmedian $1,148 · 10th to 90th $676 to $1,778
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 $630.96 Median $630.96 Typical High $7,943.28 | Facility | None | $630.96 | $630.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,000.00 | Professional | None | $630.96 | $630.96 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,365.16 | Facility | None | $2,187.76 | $3,162.28 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,905.46 | Professional | None | $776.25 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,890.45 | Facility | None | $602.56 | $2,398.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,584.89 | Professional | None | $741.31 | $741.31 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,096.48 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $1,023.29 Typical High $4,365.16 | Facility | None | $660.69 | $1,023.29 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,230.27 | Professional | None | $776.25 | $933.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,548.82 | Professional | None | $549.54 | $724.44 | $1,548.82 |
8 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 $316.23 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,445.44 Typical High $2,290.87 | Professional | 50 · Both sides | $1,258.93 | $1,445.44 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $478.63 Typical High $758.58 | Professional | 51 · Multiple procedures | $416.87 | $478.63 | $758.58 |
Where North Carolina sits
The same service costs 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.