How much rates vary
Facilitymedian $1,349 · 10th to 90th $372 to $3,020Professionalmedian $251 · 10th to 90th $138 to $490
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 $125.89 Median $190.55 Typical High $7,413.10 | Facility | None | $125.89 | $190.55 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $251.19 | Professional | None | $125.89 | $190.55 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $524.81 | Professional | None | $190.55 | $309.03 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,513.56 Typical High $2,238.72 | Facility | None | $457.09 | $1,513.56 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $426.58 | Professional | None | $134.90 | $223.87 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $549.54 Typical High $1,548.82 | Facility | None | $223.87 | $549.54 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $316.23 | Professional | None | $186.21 | $245.47 | $316.23 |
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 $128.82 Median $194.98 Typical High $416.87 | Professional | None | $128.82 | $194.98 | $416.87 |
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 $63.10 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $63.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $131.83 Typical High $151.36 | Professional | 54 · Surgery only | $95.50 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $123.03 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $89.13 | $123.03 | $141.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $436.52 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $186.21 | $436.52 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $93.33 Median $154.88 Typical High $263.03 | Professional | 51 · Multiple procedures | $93.33 | $154.88 | $263.03 |
Where North Carolina sits
The same service costs 9.9 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 $4,605MT $466
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.