How much rates vary
Facilitymedian $1,862 · 10th to 90th $525 to $7,413Professionalmedian $661 · 10th to 90th $417 to $1,288
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 $354.81 Median $524.81 Typical High $6,760.83 | Facility | None | $354.81 | $524.81 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $741.31 | Professional | None | $354.81 | $524.81 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $436.52 Median $776.25 Typical High $1,445.44 | Professional | None | $436.52 | $776.25 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $1,096.48 | Professional | None | $407.38 | $524.81 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Professional | None | $741.31 | $741.31 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $977.24 Typical High $5,011.87 | Facility | None | $562.34 | $977.24 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $933.25 | Professional | None | $512.86 | $645.65 | $933.25 |
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 $338.84 Median $524.81 Typical High $1,096.48 | Professional | None | $338.84 | $524.81 | $1,096.48 |
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 $177.83 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $263.03 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $35.48 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $245.47 | $354.81 | $380.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,445.44 Typical High $7,943.28 | Facility | 50 · Both sides | $891.25 | $1,445.44 | $7,943.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $2,630.27 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $2,630.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $1,949.84 | Professional | 50 · Both sides | $776.25 | $977.24 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $323.59 Typical High $645.65 | Professional | 51 · Multiple procedures | $257.04 | $323.59 | $645.65 |
Where North Carolina sits
The same service costs 6.4 times more in Alaska 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
AK $8,723MT $1,361
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.