How much rates vary
Facilitymedian $4,169 · 10th to 90th $646 to $11,749Professionalmedian $776 · 10th to 90th $537 to $1,514
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 $549.54 Median $660.69 Typical High $7,943.28 | Facility | None | $549.54 | $660.69 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $870.96 | Professional | None | $549.54 | $549.54 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,691.53 Median $3,715.35 Typical High $11,748.98 | Facility | None | $2,691.53 | $3,715.35 | $11,748.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,548.82 | Professional | None | $707.95 | $912.01 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,456.54 Typical High $9,549.93 | Facility | None | $794.33 | $6,456.54 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $1,318.26 | Professional | None | $501.19 | $549.54 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,288.25 | Professional | None | $758.58 | $758.58 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,079.46 | Facility | None | $707.95 | $1,905.46 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $933.25 | Professional | None | $602.56 | $660.69 | $933.25 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,380.38 | Professional | None | $457.09 | $575.44 | $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 $275.42 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,148.15 Typical High $4,786.30 | Facility | 51 · Multiple procedures | $363.08 | $1,148.15 | $4,786.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $346.74 Typical High $676.08 | Professional | 51 · Multiple procedures | $302.00 | $346.74 | $676.08 |
Where North Carolina sits
The same service costs 7.5 times more in Colorado 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
CO $13,659MT $1,825
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.