How much rates vary
Facilitymedian $174 · 10th to 90th $81 to $891Professionalmedian $240 · 10th to 90th $162 to $468
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 $144.54 Median $173.78 Typical High $5,495.41 | Facility | None | $144.54 | $173.78 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $281.84 | Professional | None | $144.54 | $173.78 | $281.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $489.78 | Professional | None | $199.53 | $281.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $199.53 Typical High $323.59 | Facility | None | $56.23 | $199.53 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $398.11 | Professional | None | $162.18 | $173.78 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | None | $239.88 | $239.88 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $309.03 | Facility | None | $87.10 | $128.82 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $295.12 | Professional | None | $169.82 | $204.17 | $295.12 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $398.11 | Professional | None | $134.90 | $177.83 | $398.11 |
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 $72.44 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $72.44 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $28.84 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.45 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $128.82 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $190.55 Typical High $467.74 | Facility | 50 · Both sides | $123.03 | $190.55 | $467.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $154.88 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $302.00 Typical High $660.69 | Professional | 50 · Both sides | $251.19 | $302.00 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $102.33 Typical High $218.78 | Professional | 51 · Multiple procedures | $85.11 | $102.33 | $218.78 |
Where North Carolina sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 16th of 51
$240
AK $617FL $135
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.