How much rates vary
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 $257.04 Median $354.81 Typical High $7,244.36 | Facility | None | $257.04 | $354.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $407.38 | Professional | None | $257.04 | $354.81 | $407.38 |
BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,023.29 | Professional | None | $371.54 | $616.60 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,951.21 | Facility | None | $602.56 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $616.60 | Professional | None | $295.12 | $354.81 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $870.96 | Professional | None | $501.19 | $501.19 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $1,949.84 | Facility | None | $416.87 | $707.95 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $446.68 | Professional | None | $316.23 | $398.11 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $562.34 | Professional | None | $257.04 | $346.74 | $562.34 |
8 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 $128.82 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $257.04 Typical High $281.84 | Professional | 54 · Surgery only | $194.98 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $181.97 | $239.88 | $263.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $489.78 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $257.04 | $489.78 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $199.53 Typical High $257.04 | Professional | 51 · Multiple procedures | $158.49 | $199.53 | $257.04 |
Where North Carolina sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 10th of 51
$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.