How much rates vary
Facilitymedian $2,399 · 10th to 90th $741 to $7,413Professionalmedian $676 · 10th to 90th $427 to $1,122
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 $10,471.29 | Facility | None | $407.38 | $1,000.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $7,585.78 | Facility | None | $1,905.46 | $2,884.03 | $7,585.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,148.15 | Professional | None | $549.54 | $794.33 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,388.44 | Facility | None | $794.33 | $2,511.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,096.48 | Professional | None | $446.68 | $575.44 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $2,511.89 | Facility | None | $707.95 | $1,698.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $676.08 | Professional | None | $489.78 | $562.34 | $676.08 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,023.29 | Professional | None | $389.05 | $501.19 | $1,023.29 |
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 $245.47 | Professional | 52 · Reduced service | $199.53 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $338.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $851.14 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $363.08 | $851.14 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $281.84 Typical High $588.84 | Professional | 51 · Multiple procedures | $257.04 | $281.84 | $588.84 |
Where North Carolina sits
The same service costs 5.8 times more in Oklahoma 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
OK $7,629MT $1,321
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.