How much rates vary
Facilitymedian $1,862 · 10th to 90th $525 to $5,623Professionalmedian $479 · 10th to 90th $251 to $977
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 $257.04 Median $398.11 Typical High $7,943.28 | Facility | None | $257.04 | $398.11 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $467.74 | Professional | None | $257.04 | $380.19 | $467.74 |
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 $251.19 Median $562.34 Typical High $1,023.29 | Professional | None | $251.19 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $794.33 | Professional | None | $295.12 | $380.19 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $954.99 | Professional | None | $524.81 | $524.81 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $2,398.83 | Facility | None | $446.68 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $758.58 | Professional | None | $478.63 | $537.03 | $758.58 |
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 $245.47 Median $389.05 Typical High $831.76 | Professional | None | $245.47 | $389.05 | $831.76 |
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 $128.82 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $194.98 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $181.97 | $263.03 | $275.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $275.42 Typical High $467.74 | Professional | 51 · Multiple procedures | $239.88 | $275.42 | $467.74 |
Where North Carolina sits
The same service costs 6.3 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 $1,002
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.