How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $4,898Professionalmedian $1,072 · 10th to 90th $589 to $1,738
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 $616.60 Median $1,288.25 Typical High $8,317.64 | Facility | None | $616.60 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $2,630.27 | Facility | None | $1,288.25 | $1,949.84 | $2,630.27 |
BCBS North Carolina Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,737.80 | Professional | None | $741.31 | $1,122.02 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,818.38 | Facility | None | $645.65 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $1,202.26 | Professional | None | $562.34 | $575.44 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,445.44 | Professional | None | $851.14 | $851.14 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,041.74 | Facility | None | $588.84 | $977.24 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $707.95 | Professional | None | $575.44 | $602.56 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | None | $489.78 | $489.78 | $512.86 |
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 $501.19 Median $616.60 Typical High $1,148.15 | Professional | None | $501.19 | $616.60 | $1,148.15 |
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 $309.03 Median $309.03 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $501.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $562.34 Typical High $1,513.56 | Facility | 51 · Multiple procedures | $295.12 | $562.34 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $302.00 Typical High $354.81 | Professional | 51 · Multiple procedures | $288.40 | $302.00 | $354.81 |
Where North Carolina sits
The same service costs 5.6 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· 12th of 51
$1,072
AK $2,512TX $447
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.