How much rates vary
Facilitymedian $1,738 · 10th to 90th $525 to $5,248Professionalmedian $724 · 10th to 90th $457 to $1,288
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 $407.38 Median $537.03 Typical High $5,248.07 | Facility | None | $407.38 | $537.03 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $724.44 | Professional | None | $407.38 | $524.81 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $524.81 | Professional | None | $331.13 | $524.81 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,137.96 | $5,495.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,445.44 | Professional | None | $549.54 | $891.25 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $3,162.28 | Facility | None | $602.56 | $2,137.96 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,258.93 | Professional | None | $457.09 | $588.84 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $2,187.76 | Facility | None | $512.86 | $977.24 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $851.14 | Professional | None | $501.19 | $630.96 | $851.14 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,148.15 | Professional | None | $416.87 | $588.84 | $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 $204.17 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $363.08 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,698.24 Typical High $4,265.80 | Facility | 50 · Both sides | $776.25 | $1,698.24 | $4,265.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $562.34 Typical High $1,412.54 | Facility | 51 · Multiple procedures | $257.04 | $562.34 | $1,412.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $954.99 Typical High $2,238.72 | Professional | 50 · Both sides | $741.31 | $954.99 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $316.23 Typical High $741.31 | Professional | 51 · Multiple procedures | $251.19 | $316.23 | $741.31 |
Where North Carolina sits
The same service costs 5.4 times more in Wisconsin than in West Virginia. 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
WI $6,411WV $1,178
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.