How much rates vary
Facilitymedian $1,905 · 10th to 90th $646 to $5,623Professionalmedian $1,096 · 10th to 90th $617 to $1,622
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 $478.63 Median $645.65 Typical High $8,511.38 | Facility | None | $478.63 | $645.65 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $676.08 | Professional | None | $478.63 | $645.65 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $676.08 Median $1,318.26 Typical High $1,778.28 | Professional | None | $676.08 | $1,318.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,445.44 | Professional | None | $602.56 | $707.95 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,023.29 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,570.40 | Facility | None | $707.95 | $1,000.00 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,071.52 | Professional | None | $776.25 | $870.96 | $1,071.52 |
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 $457.09 Median $660.69 Typical High $1,380.38 | Professional | None | $457.09 | $660.69 | $1,380.38 |
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 $239.88 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $239.88 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $95.50 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $354.81 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $47.86 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $331.13 | $436.52 | $467.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $562.34 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $562.34 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $436.52 Typical High $776.25 | Professional | 51 · Multiple procedures | $416.87 | $436.52 | $776.25 |
Where North Carolina sits
The same service costs 5.8 times more in Alaska than in Texas. 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· 7th of 51
$1,096
AK $2,455TX $427
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.