How much rates vary
Facilitymedian $2,399 · 10th to 90th $646 to $5,888Professionalmedian $912 · 10th to 90th $575 to $1,660
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 $562.34 Median $1,288.25 Typical High $8,317.64 | Facility | None | $562.34 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,288.25 | Professional | None | $562.34 | $562.34 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $4,677.35 | Facility | None | $2,344.23 | $3,467.37 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,778.28 | Professional | None | $645.65 | $1,096.48 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,187.76 Typical High $3,235.94 | Facility | None | $645.65 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,548.82 | Professional | None | $741.31 | $851.14 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,202.26 Typical High $2,691.53 | Facility | None | $588.84 | $1,202.26 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,174.90 | Professional | None | $602.56 | $812.83 | $1,174.90 |
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 $575.44 Median $891.25 Typical High $1,548.82 | Professional | None | $575.44 | $891.25 | $1,548.82 |
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 $281.84 Median $281.84 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $501.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,818.38 Typical High $5,248.07 | Facility | 50 · Both sides | $891.25 | $2,818.38 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $933.25 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $295.12 | $933.25 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,258.93 Typical High $2,454.71 | Professional | 50 · Both sides | $912.01 | $1,258.93 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $416.87 Typical High $831.76 | Professional | 51 · Multiple procedures | $302.00 | $416.87 | $831.76 |
Where North Carolina sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 24th of 51
$1,096
AK $3,236TX $550
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.