How much rates vary
Facilitymedian $1,778 · 10th to 90th $562 to $5,129Professionalmedian $575 · 10th to 90th $355 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 $309.03 Median $467.74 Typical High $7,943.28 | Facility | None | $309.03 | $467.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $562.34 | Professional | None | $309.03 | $467.74 | $562.34 |
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 $436.52 Median $660.69 Typical High $1,202.26 | Professional | None | $436.52 | $660.69 | $1,202.26 |
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 $346.74 Median $436.52 Typical High $954.99 | Professional | None | $346.74 | $436.52 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,148.15 | Professional | None | $602.56 | $602.56 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $2,398.83 | Facility | None | $501.19 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $812.83 | Professional | None | $457.09 | $537.03 | $812.83 |
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 $295.12 Median $457.09 Typical High $954.99 | Professional | None | $295.12 | $457.09 | $954.99 |
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 $154.88 Median $223.87 Typical High $234.42 | Professional | 52 · Reduced service | $154.88 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $95.50 | Professional | 53 · Discontinued | $61.66 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $309.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $218.78 | $309.03 | $331.13 |
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 $229.09 Median $269.15 Typical High $562.34 | Professional | 51 · Multiple procedures | $229.09 | $269.15 | $562.34 |
Where North Carolina sits
The same service costs 11.0 times more in Vermont 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
VT $12,892MT $1,170
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.