How much rates vary
Facilitymedian $631 · 10th to 90th $309 to $5,754Professionalmedian $631 · 10th to 90th $363 to $1,514
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 $263.03 Median $426.58 Typical High $7,943.28 | Facility | None | $263.03 | $426.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $831.76 | Professional | None | $263.03 | $426.58 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $602.56 | Professional | None | $346.74 | $363.08 | $602.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $354.81 Median $524.81 Typical High $707.95 | Facility | None | $354.81 | $524.81 | $707.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,659.59 | Professional | None | $467.74 | $794.33 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $831.76 | Facility | None | $263.03 | $416.87 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,380.38 | Professional | None | $389.05 | $616.60 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $870.96 | Facility | None | $363.08 | $501.19 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,023.29 | Professional | None | $436.52 | $691.83 | $1,023.29 |
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 $363.08 Median $630.96 Typical High $1,148.15 | Professional | None | $363.08 | $630.96 | $1,148.15 |
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 $131.83 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $131.83 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $52.48 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $316.23 Typical High $363.08 | Professional | 54 · Surgery only | $199.53 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $39.81 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.30 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $295.12 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $186.21 | $295.12 | $338.84 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $575.44 Median $954.99 Typical High $1,348.96 | Facility | 50 · Both sides | $575.44 | $954.99 | $1,348.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $190.55 Median $316.23 Typical High $446.68 | Facility | 51 · Multiple procedures | $190.55 | $316.23 | $446.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,148.15 Typical High $1,862.09 | Professional | 50 · Both sides | $660.69 | $1,148.15 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $380.19 Typical High $616.60 | Professional | 51 · Multiple procedures | $218.78 | $380.19 | $616.60 |
Where North Carolina sits
The same service costs 4.1 times more in Wisconsin 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
$631
WI $1,549TX $380
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.