How much rates vary
Facilitymedian $1,230 · 10th to 90th $389 to $3,467Professionalmedian $162 · 10th to 90th $85 to $234
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 $74.13 Median $1,000.00 Typical High $7,943.28 | Facility | None | $74.13 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $151.36 | Professional | None | $74.13 | $74.13 | $151.36 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,548.13 | Facility | None | $891.25 | $1,380.38 | $3,548.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $251.19 | Professional | None | $114.82 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,995.26 | Facility | None | $457.09 | $1,348.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $208.93 | Professional | None | $95.50 | $112.20 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $1,412.54 | Facility | None | $371.54 | $602.56 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $165.96 | Professional | None | $77.62 | $107.15 | $165.96 |
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 $77.62 Median $104.71 Typical High $190.55 | Professional | None | $77.62 | $104.71 | $190.55 |
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 $37.15 Median $37.15 Typical High $45.71 | Professional | 52 · Reduced service | $37.15 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $18.20 | Professional | 53 · Discontinued | $14.79 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | 54 · Surgery only | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $52.48 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $52.48 | $52.48 | $64.57 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,096.48 Typical High $3,162.28 | Facility | 50 · Both sides | $562.34 | $1,096.48 | $3,162.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $371.54 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $186.21 | $371.54 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $204.17 Typical High $331.13 | Professional | 50 · Both sides | $138.04 | $204.17 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $69.18 Typical High $109.65 | Professional | 51 · Multiple procedures | $46.77 | $69.18 | $109.65 |
Where North Carolina sits
The same service costs 18.4 times more in Colorado than in Montana. 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 $4,483MT $243
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.