How much rates vary
Facilitymedian $1,778 · 10th to 90th $562 to $5,495Professionalmedian $776 · 10th to 90th $437 to $1,259
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 $416.87 Median $1,148.15 Typical High $7,943.28 | Facility | None | $416.87 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $831.76 | Professional | None | $416.87 | $416.87 | $831.76 |
BCBS North Carolina 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 North Carolina Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,258.93 | Professional | None | $588.84 | $794.33 | $1,258.93 |
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 $467.74 Median $549.54 Typical High $1,122.02 | Professional | None | $467.74 | $549.54 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,949.84 | Facility | None | $512.86 | $977.24 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $691.83 | Professional | None | $398.11 | $549.54 | $691.83 |
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 $426.58 Median $512.86 Typical High $1,023.29 | Professional | None | $426.58 | $512.86 | $1,023.29 |
8 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 $208.93 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $354.81 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $549.54 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $257.04 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $323.59 Typical High $602.56 | Professional | 51 · Multiple procedures | $199.53 | $323.59 | $602.56 |
Where North Carolina sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.