How much rates vary
Facilitymedian $363 · 10th to 90th $214 to $2,042Professionalmedian $417 · 10th to 90th $214 to $708
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 $158.49 Median $251.19 Typical High $7,244.36 | Facility | None | $158.49 | $251.19 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $302.00 | Professional | None | $158.49 | $251.19 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $371.54 | Facility | None | $181.97 | $275.42 | $371.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $724.44 | Professional | None | $257.04 | $416.87 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $758.58 | Facility | None | $213.80 | $346.74 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | None | $199.53 | $239.88 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $616.60 | Professional | None | $338.84 | $338.84 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $512.86 | Facility | None | $223.87 | $346.74 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $316.23 | Professional | None | $229.09 | $245.47 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | None | $213.80 | $213.80 | $229.09 |
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 $165.96 Median $239.88 Typical High $389.05 | Professional | None | $165.96 | $239.88 | $389.05 |
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 $79.43 Median $120.23 Typical High $131.83 | Professional | 52 · Reduced service | $79.43 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $31.62 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $120.23 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $169.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $112.20 | $169.82 | $186.21 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $131.83 Median $173.78 Typical High $257.04 | Facility | 51 · Multiple procedures | $131.83 | $173.78 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $147.91 Typical High $173.78 | Professional | 51 · Multiple procedures | $114.82 | $147.91 | $173.78 |
Where North Carolina sits
The same service costs 3.6 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· 7th of 51
$417
AK $646TX $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.