How much rates vary
Facilitymedian $1,778 · 10th to 90th $513 to $5,370Professionalmedian $513 · 10th to 90th $200 to $1,047
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 $251.19 Median $380.19 Typical High $7,585.78 | Facility | None | $251.19 | $380.19 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $436.52 | Professional | None | $251.19 | $380.19 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,862.09 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $199.53 Median $616.60 Typical High $1,096.48 | Professional | None | $199.53 | $616.60 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,235.94 | Facility | None | $602.56 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $851.14 | Professional | None | $331.13 | $398.11 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,047.13 | Professional | None | $575.44 | $575.44 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $977.24 Typical High $2,398.83 | Facility | None | $426.58 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $630.96 | Professional | None | $416.87 | $501.19 | $630.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $831.76 | Professional | None | $257.04 | $407.38 | $831.76 |
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 $125.89 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $125.89 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $50.12 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $173.78 | $257.04 | $275.42 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,445.44 Typical High $5,011.87 | Facility | 50 · Both sides | $776.25 | $1,445.44 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $263.03 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $758.58 Typical High $1,380.38 | Professional | 50 · Both sides | $616.60 | $758.58 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $251.19 Typical High $457.09 | Professional | 51 · Multiple procedures | $204.17 | $251.19 | $457.09 |
Where North Carolina sits
The same service costs 6.1 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 $6,296MT $1,039
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.