How much rates vary
Facilitymedian $1,698 · 10th to 90th $288 to $4,365Professionalmedian $437 · 10th to 90th $229 to $1,023
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 $173.78 Median $288.40 Typical High $1,584.89 | Facility | None | $173.78 | $288.40 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $489.78 | Professional | None | $173.78 | $288.40 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $741.31 Typical High $776.25 | Professional | None | $74.13 | $741.31 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,995.26 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $1,096.48 | Professional | None | $354.81 | $616.60 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,951.21 | Facility | None | $602.56 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $758.58 | Professional | None | $251.19 | $426.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $977.24 Typical High $2,089.30 | Facility | None | $331.13 | $977.24 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $630.96 | Professional | None | $331.13 | $478.63 | $630.96 |
Oscar Health Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $8,511.38 | Facility | None | $2,511.89 | $2,511.89 | $8,511.38 |
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 $177.83 Median $389.05 Typical High $724.44 | Professional | None | $177.83 | $389.05 | $724.44 |
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 $87.10 Median $144.54 Typical High $154.88 | Professional | 52 · Reduced service | $87.10 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $57.54 Typical High $61.66 | Professional | 53 · Discontinued | $34.67 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $131.83 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $43.65 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $28.84 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.38 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $204.17 | $218.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,659.59 Typical High $3,890.45 | Facility | 50 · Both sides | $776.25 | $1,659.59 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $549.54 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $263.03 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $776.25 Typical High $1,174.90 | Professional | 50 · Both sides | $602.56 | $776.25 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | 51 · Multiple procedures | $199.53 | $263.03 | $398.11 |
Where North Carolina sits
The same service costs 7.6 times more in Colorado than in West Virginia. 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 $4,696WV $618
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.