How much rates vary
Facilitymedian $1,259 · 10th to 90th $447 to $4,898Professionalmedian $562 · 10th to 90th $363 to $1,122
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 $302.00 Median $446.68 Typical High $5,248.07 | Facility | None | $302.00 | $446.68 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $616.60 | Professional | None | $302.00 | $446.68 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $426.58 Median $676.08 Typical High $1,230.27 | Professional | None | $426.58 | $676.08 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $2,089.30 | Facility | None | $645.65 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $933.25 | Professional | None | $354.81 | $446.68 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,096.48 | Professional | None | $630.96 | $630.96 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $977.24 Typical High $1,737.80 | Facility | None | $478.63 | $977.24 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | None | $446.68 | $549.54 | $794.33 |
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 $288.40 Median $446.68 Typical High $933.25 | Professional | None | $288.40 | $446.68 | $933.25 |
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 $151.36 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $44.67 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $323.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,445.44 Typical High $2,818.38 | Facility | 50 · Both sides | $891.25 | $1,445.44 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $933.25 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $812.83 Typical High $1,621.81 | Professional | 50 · Both sides | $676.08 | $812.83 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $269.15 Typical High $549.54 | Professional | 51 · Multiple procedures | $223.87 | $269.15 | $549.54 |
Where North Carolina sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.