How much rates vary
Facilitymedian $30,903 · 10th to 90th $891 to $50,119Professionalmedian $1,549 · 10th to 90th $933 to $2,512
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 $891.25 Median $1,174.90 Typical High $15,135.61 | Facility | None | $891.25 | $1,174.90 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,819.70 | Professional | None | $891.25 | $933.25 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,258.93 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,897.79 Median $7,762.47 Typical High $19,498.45 | Facility | None | $4,897.79 | $7,762.47 | $19,498.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,905.46 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $35,481.34 Typical High $48,977.88 | Facility | None | $602.56 | $35,481.34 | $48,977.88 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,318.26 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $47,863.01 Typical High $48,977.88 | Facility | None | $1,659.59 | $47,863.01 | $48,977.88 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $1,949.84 | Professional | None | $912.01 | $1,445.44 | $1,949.84 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $28,840.32 Typical High $74,131.02 | Facility | None | $2,344.23 | $28,840.32 | $74,131.02 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,454.71 | Professional | None | $912.01 | $1,288.25 | $2,454.71 |
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 $446.68 Median $446.68 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $794.33 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $15,488.17 Median $24,547.09 Typical High $36,307.81 | Facility | 51 · Multiple procedures | $15,488.17 | $24,547.09 | $36,307.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $724.44 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $457.09 | $724.44 | $1,288.25 |
Where North Carolina sits
The same service costs 19.9 times more in Alaska 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
AK $53,750MT $2,699
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.