How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $7,413Professionalmedian $1,096 · 10th to 90th $537 to $1,950
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 $794.33 Median $794.33 Typical High $7,943.28 | Facility | None | $794.33 | $794.33 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | None | $794.33 | $794.33 | $977.24 |
BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $5,370.32 | Facility | None | $1,348.96 | $2,137.96 | $5,370.32 |
BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,380.38 Typical High $1,995.26 | Professional | None | $537.03 | $1,380.38 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $7,244.36 | Facility | None | $602.56 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,995.26 | Professional | None | $831.76 | $1,000.00 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $4,265.80 | Facility | None | $1,096.48 | $1,737.80 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,318.26 | Professional | None | $794.33 | $933.25 | $1,318.26 |
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 $724.44 Median $954.99 Typical High $1,949.84 | Professional | None | $724.44 | $954.99 | $1,949.84 |
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 $398.11 Median $398.11 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,659.59 Median $2,570.40 Typical High $8,709.64 | Facility | 50 · Both sides | $1,659.59 | $2,570.40 | $8,709.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $549.54 Median $870.96 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $549.54 | $870.96 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,380.38 Typical High $3,311.31 | Professional | 50 · Both sides | $1,202.26 | $1,380.38 | $3,311.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $457.09 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $398.11 | $457.09 | $1,096.48 |
Where North Carolina sits
The same service costs 5.2 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.
Physician feeFacility fee
AK $9,768KY $1,881
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.