How much rates vary
Facilitymedian $1,950 · 10th to 90th $537 to $6,310Professionalmedian $692 · 10th to 90th $417 to $1,230
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 $446.68 Typical High $7,585.78 | Facility | None | $323.59 | $446.68 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $524.81 | Professional | None | $323.59 | $446.68 | $524.81 |
BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,288.25 | Professional | None | $467.74 | $741.31 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $776.25 | Professional | None | $371.54 | $457.09 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,122.02 | Professional | None | $645.65 | $645.65 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $4,677.35 | Facility | None | $512.86 | $977.24 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $575.44 | Professional | None | $416.87 | $478.63 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
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 $323.59 Median $436.52 Typical High $724.44 | Professional | None | $323.59 | $436.52 | $724.44 |
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 $162.18 Median $213.80 Typical High $234.42 | Professional | 52 · Reduced service | $162.18 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $245.47 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $42.66 Typical High $46.77 | Professional | 56 · Pre-op care only | $32.36 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $331.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $263.03 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $257.04 Typical High $302.00 | Professional | 51 · Multiple procedures | $208.93 | $257.04 | $302.00 |
Where North Carolina sits
The same service costs 4.0 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· 9th of 51
$708
AK $1,318NJ $331
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.