How much rates vary
Facilitymedian $2,089 · 10th to 90th $676 to $6,918Professionalmedian $977 · 10th to 90th $692 to $1,995
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 $676.08 Median $912.01 Typical High $8,317.64 | Facility | None | $676.08 | $912.01 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,202.26 | Professional | None | $676.08 | $676.08 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $1,122.02 Typical High $1,202.26 | Professional | None | $467.74 | $1,122.02 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,621.81 | $2,511.89 | $6,456.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,041.74 | Professional | None | $870.96 | $1,148.15 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,890.45 | Facility | None | $645.65 | $2,290.87 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,737.80 | Professional | None | $741.31 | $776.25 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,122.02 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,288.25 Typical High $2,884.03 | Facility | None | $602.56 | $1,288.25 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,380.38 | Professional | None | $812.83 | $954.99 | $1,380.38 |
Oscar Health Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $20,417.38 | Facility | None | $1,905.46 | $1,905.46 | $20,417.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,630.27 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,630.27 | $12,022.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,698.24 | Professional | None | $575.44 | $758.58 | $1,698.24 |
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 $338.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $549.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,949.84 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $1,949.84 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $645.65 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $645.65 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,584.89 Typical High $2,691.53 | Professional | 50 · Both sides | $1,288.25 | $1,584.89 | $2,691.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $524.81 Typical High $891.25 | Professional | 51 · Multiple procedures | $426.58 | $524.81 | $891.25 |
Where North Carolina sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,904MT $2,218
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.