How much rates vary
Facilitymedian $2,291 · 10th to 90th $676 to $6,310Professionalmedian $1,175 · 10th to 90th $646 to $1,820
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 $616.60 Median $1,584.89 Typical High $10,964.78 | Facility | None | $616.60 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | None | $616.60 | $616.60 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,162.28 | Facility | None | $1,584.89 | $2,344.23 | $3,162.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,862.09 | Professional | None | $776.25 | $1,174.90 | $1,862.09 |
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 $660.69 Median $691.83 Typical High $1,548.82 | Professional | None | $660.69 | $691.83 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,000.00 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,288.25 Typical High $2,398.83 | Facility | None | $602.56 | $1,288.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,047.13 | Professional | None | $707.95 | $776.25 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,570.40 | $12,022.64 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,548.82 | Professional | None | $537.03 | $691.83 | $1,548.82 |
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 $309.03 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $501.19 |
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 $1,071.52 Median $1,148.15 Typical High $2,290.87 | Professional | 50 · Both sides | $1,071.52 | $1,148.15 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $389.05 Typical High $758.58 | Professional | 51 · Multiple procedures | $354.81 | $389.05 | $758.58 |
Where North Carolina sits
The same service costs 7.4 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· 11th of 51
$1,175
AK $2,630TX $355
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.