How much rates vary
Facilitymedian $3,890 · 10th to 90th $851 to $12,023Professionalmedian $1,549 · 10th to 90th $891 to $2,344
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 $851.14 Median $1,288.25 Typical High $10,471.29 | Facility | None | $851.14 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,513.56 | Professional | None | $851.14 | $851.14 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $3,890.45 Typical High $10,000.00 | Facility | None | $2,511.89 | $3,890.45 | $10,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,621.81 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,244.36 Typical High $12,022.64 | Facility | None | $602.56 | $7,244.36 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,290.87 | Professional | None | $954.99 | $1,148.15 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $7,244.36 | Facility | None | $1,659.59 | $3,090.30 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,202.26 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,862.09 | Professional | None | $851.14 | $1,096.48 | $1,862.09 |
10 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 $426.58 Median $426.58 Typical High $457.09 | Professional | 52 · Reduced service | $426.58 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $645.65 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $3,019.95 Median $4,677.35 Typical High $15,488.17 | Facility | 50 · Both sides | $3,019.95 | $4,677.35 | $15,488.17 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,548.82 Typical High $5,128.61 | Facility | 51 · Multiple procedures | $1,000.00 | $1,548.82 | $5,128.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,137.96 Typical High $3,388.44 | Professional | 50 · Both sides | $1,698.24 | $2,137.96 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $707.95 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $562.34 | $707.95 | $1,122.02 |
Where North Carolina sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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.
Physician feeFacility fee
CO $14,612KY $2,222
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.