How much rates vary
Facilitymedian $1,585 · 10th to 90th $676 to $4,571Professionalmedian $479 · 10th to 90th $324 to $933
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 $316.23 Median $489.78 Typical High $8,511.38 | Facility | None | $316.23 | $489.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $524.81 | Professional | None | $316.23 | $316.23 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $630.96 Typical High $954.99 | Professional | None | $436.52 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,659.59 Typical High $2,570.40 | Facility | None | $794.33 | $1,659.59 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $831.76 | Professional | None | $363.08 | $446.68 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,412.54 | Facility | None | $676.08 | $1,047.13 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $602.56 | Professional | None | $380.19 | $436.52 | $602.56 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $794.33 | Professional | None | $302.00 | $389.05 | $794.33 |
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 $190.55 | Professional | 52 · Reduced service | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $263.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,659.59 Typical High $3,162.28 | Facility | 50 · Both sides | $1,096.48 | $1,659.59 | $3,162.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $562.34 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $363.08 | $562.34 | $1,047.13 |
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 $457.09 | Professional | 51 · Multiple procedures | $199.53 | $218.78 | $457.09 |
Where North Carolina sits
The same service costs 5.1 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 $5,094MT $991
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.