How much rates vary
Facilitymedian $209 · 10th to 90th $72 to $1,000Professionalmedian $759 · 10th to 90th $427 to $1,096
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 $1,000.00 Typical High $7,943.28 | Facility | None | $407.38 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | None | $407.38 | $407.38 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $234.42 | Facility | None | $58.88 | $91.20 | $234.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,174.90 | Professional | None | $537.03 | $758.58 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $194.98 Typical High $316.23 | Facility | None | $56.23 | $194.98 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $794.33 | Professional | None | $436.52 | $436.52 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $977.24 | Professional | None | $616.60 | $616.60 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $398.11 Typical High $724.44 | Facility | None | $51.29 | $398.11 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $549.54 | Professional | None | $389.05 | $446.68 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | None | $389.05 | $389.05 | $407.38 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $776.25 | Professional | None | $346.74 | $426.58 | $776.25 |
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 $199.53 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $323.59 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $25.70 Median $141.25 Typical High $363.08 | Facility | 51 · Multiple procedures | $25.70 | $141.25 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $223.87 Typical High $288.40 | Professional | 51 · Multiple procedures | $194.98 | $223.87 | $288.40 |
Where North Carolina sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 8th of 51
$759
WY $1,288UT $309
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.