How much rates vary
Facilitymedian $2,089 · 10th to 90th $603 to $5,754Professionalmedian $380 · 10th to 90th $240 to $708
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 $239.88 Median $1,148.15 Typical High $7,943.28 | Facility | None | $239.88 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $407.38 | Professional | None | $239.88 | $239.88 | $407.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,412.54 | $2,137.96 | $2,884.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $741.31 | Professional | None | $281.84 | $436.52 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,235.94 | Facility | None | $602.56 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $660.69 | Professional | None | $295.12 | $354.81 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $977.24 Typical High $2,454.71 | Facility | None | $489.78 | $977.24 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $524.81 | Professional | None | $239.88 | $389.05 | $524.81 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $645.65 | Professional | None | $239.88 | $354.81 | $645.65 |
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 $120.23 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $218.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,819.70 Typical High $5,248.07 | Facility | 50 · Both sides | $776.25 | $1,819.70 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $602.56 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $257.04 | $602.56 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $630.96 Typical High $1,071.52 | Professional | 50 · Both sides | $363.08 | $630.96 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $213.80 Typical High $354.81 | Professional | 51 · Multiple procedures | $120.23 | $213.80 | $354.81 |
Where North Carolina sits
The same service costs 9.3 times more in Vermont 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
VT $7,005MT $753
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.