How much rates vary
Facilitymedian $977 · 10th to 90th $447 to $3,162Professionalmedian $575 · 10th to 90th $372 to $1,148
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 $7,244.36 | Facility | None | $302.00 | $446.68 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $645.65 | Professional | None | $302.00 | $446.68 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,715.35 | Facility | None | $933.25 | $1,445.44 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,230.27 | Professional | None | $436.52 | $691.83 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $954.99 | Professional | None | $371.54 | $457.09 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $1,479.11 | Facility | None | $489.78 | $707.95 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $831.76 | Professional | None | $426.58 | $549.54 | $831.76 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $933.25 | Professional | None | $295.12 | $457.09 | $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 $234.42 | Professional | 52 · Reduced service | $151.36 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $229.09 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $45.71 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $213.80 | $295.12 | $323.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,258.93 Typical High $2,187.76 | Facility | 50 · Both sides | $776.25 | $1,258.93 | $2,187.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $426.58 Typical High $724.44 | Facility | 51 · Multiple procedures | $263.03 | $426.58 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $831.76 Typical High $1,621.81 | Professional | 50 · Both sides | $645.65 | $831.76 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $275.42 Typical High $537.03 | Professional | 51 · Multiple procedures | $213.80 | $275.42 | $537.03 |
Where North Carolina sits
The same service costs 4.9 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· 13th of 51
$589
AK $1,413UT $288
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.