How much rates vary
Facilitymedian $1,905 · 10th to 90th $525 to $5,623Professionalmedian $589 · 10th to 90th $355 to $1,072
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 $269.15 Median $407.38 Typical High $8,511.38 | Facility | None | $269.15 | $407.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $616.60 | Professional | None | $269.15 | $407.38 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $389.05 Median $630.96 Typical High $1,122.02 | Professional | None | $389.05 | $630.96 | $1,122.02 |
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 $354.81 Median $446.68 Typical High $912.01 | Professional | None | $354.81 | $446.68 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $977.24 | Professional | None | $645.65 | $645.65 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $977.24 Typical High $2,398.83 | Facility | None | $467.74 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $707.95 | Professional | None | $467.74 | $549.54 | $707.95 |
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 $269.15 Median $416.87 Typical High $870.96 | Professional | None | $269.15 | $416.87 | $870.96 |
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 $134.90 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $204.17 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $190.55 | $269.15 | $295.12 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,698.24 Typical High $5,011.87 | Facility | 50 · Both sides | $1,096.48 | $1,698.24 | $5,011.87 |
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 50 · Both sides Typical Low $660.69 Median $812.83 Typical High $1,548.82 | Professional | 50 · Both sides | $660.69 | $812.83 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $275.42 Typical High $512.86 | Professional | 51 · Multiple procedures | $218.78 | $275.42 | $512.86 |
Where North Carolina sits
The same service costs 5.9 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 $240
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.