How much rates vary
Facilitymedian $2,042 · 10th to 90th $589 to $5,888Professionalmedian $479 · 10th to 90th $331 to $955
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 $323.59 Median $489.78 Typical High $7,943.28 | Facility | None | $323.59 | $489.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $562.34 | Professional | None | $323.59 | $323.59 | $562.34 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,511.89 | Facility | None | $1,258.93 | $1,862.09 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $954.99 | Professional | None | $436.52 | $645.65 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,388.44 | Facility | None | $645.65 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $851.14 | Professional | None | $371.54 | $457.09 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $2,511.89 | Facility | None | $575.44 | $977.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $616.60 | Professional | None | $380.19 | $436.52 | $616.60 |
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 $309.03 Median $398.11 Typical High $812.83 | Professional | None | $309.03 | $398.11 | $812.83 |
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 $158.49 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $269.15 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,548.82 Typical High $3,715.35 | Facility | 50 · Both sides | $891.25 | $1,548.82 | $3,715.35 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $524.81 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $295.12 | $524.81 | $1,258.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $660.69 Typical High $1,380.38 | Professional | 50 · Both sides | $588.84 | $660.69 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $218.78 Typical High $467.74 | Professional | 51 · Multiple procedures | $199.53 | $218.78 | $467.74 |
Where North Carolina sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.