How much rates vary
Facilitymedian $195 · 10th to 90th $100 to $891Professionalmedian $214 · 10th to 90th $115 to $447
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 $107.15 Median $177.83 Typical High $7,413.10 | Facility | None | $107.15 | $177.83 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $208.93 | Professional | None | $107.15 | $177.83 | $208.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $537.03 | Facility | None | $134.90 | $213.80 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $512.86 | Professional | None | $114.82 | $251.19 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $194.98 Typical High $316.23 | Facility | None | $56.23 | $194.98 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $363.08 | Professional | None | $114.82 | $177.83 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $281.84 | Facility | None | $141.25 | $218.78 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $302.00 | Professional | None | $173.78 | $213.80 | $302.00 |
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 $102.33 Median $173.78 Typical High $389.05 | Professional | None | $102.33 | $173.78 | $389.05 |
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 $52.48 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $52.48 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $21.38 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $109.65 Typical High $151.36 | Professional | 54 · Surgery only | $79.43 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $102.33 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $74.13 | $102.33 | $141.25 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $213.80 Median $331.13 Typical High $426.58 | Facility | 50 · Both sides | $213.80 | $331.13 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $72.44 Median $109.65 Typical High $141.25 | Facility | 51 · Multiple procedures | $72.44 | $109.65 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $316.23 Typical High $758.58 | Professional | 50 · Both sides | $263.03 | $316.23 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $107.15 Typical High $251.19 | Professional | 51 · Multiple procedures | $87.10 | $107.15 | $251.19 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 17th of 51
$214
AK $457KY $102
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.