How much rates vary
Facilitymedian $1,698 · 10th to 90th $479 to $4,898Professionalmedian $589 · 10th to 90th $372 to $1,175
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 $316.23 Median $478.63 Typical High $5,248.07 | Facility | None | $316.23 | $478.63 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $660.69 | Professional | None | $316.23 | $478.63 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,174.90 | $1,737.80 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,258.93 | Professional | None | $389.05 | $691.83 | $1,258.93 |
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 $371.54 Median $457.09 Typical High $977.24 | Professional | None | $371.54 | $457.09 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,148.15 | Professional | None | $630.96 | $630.96 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $2,398.83 | Facility | None | $512.86 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $794.33 | Professional | None | $537.03 | $575.44 | $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 $302.00 Median $467.74 Typical High $977.24 | Professional | None | $302.00 | $467.74 | $977.24 |
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 $158.49 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $316.23 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $316.23 | $338.84 |
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 $263.03 Median $288.40 Typical High $575.44 | Professional | 51 · Multiple procedures | $263.03 | $288.40 | $575.44 |
Where North Carolina sits
The same service costs 6.4 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 $6,390WV $1,003
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.