How much rates vary
Facilitymedian $724 · 10th to 90th $347 to $6,761Professionalmedian $776 · 10th to 90th $427 to $1,820
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 $323.59 Median $489.78 Typical High $7,943.28 | Facility | None | $323.59 | $489.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $831.76 | Professional | None | $323.59 | $489.78 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $426.58 | Professional | None | $213.80 | $316.23 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $407.38 Median $616.60 Typical High $1,621.81 | Facility | None | $407.38 | $616.60 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,949.84 | Professional | None | $575.44 | $977.24 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $891.25 | Facility | None | $295.12 | $467.74 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,659.59 | Professional | None | $478.63 | $724.44 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $1,000.00 | Facility | None | $398.11 | $588.84 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $933.25 Typical High $1,230.27 | Professional | None | $467.74 | $933.25 | $1,230.27 |
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 $436.52 Median $776.25 Typical High $1,412.54 | Professional | None | $436.52 | $776.25 | $1,412.54 |
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 $162.18 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $162.18 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $64.57 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $239.88 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $48.98 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $32.36 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $223.87 | $346.74 | $398.11 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $630.96 Median $1,071.52 Typical High $1,513.56 | Facility | 50 · Both sides | $630.96 | $1,071.52 | $1,513.56 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $213.80 Median $354.81 Typical High $501.19 | Facility | 51 · Multiple procedures | $213.80 | $354.81 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,412.54 Typical High $2,187.76 | Professional | 50 · Both sides | $691.83 | $1,412.54 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $467.74 Typical High $724.44 | Professional | 51 · Multiple procedures | $234.42 | $467.74 | $724.44 |
Where North Carolina sits
The same service costs 4.3 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· 21st of 51
$776
WI $1,862TX $437
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.