How much rates vary
Facilitymedian $1,738 · 10th to 90th $513 to $5,129Professionalmedian $302 · 10th to 90th $186 to $537
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 $177.83 Median $245.47 Typical High $7,585.78 | Facility | None | $177.83 | $245.47 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $281.84 | Professional | None | $177.83 | $177.83 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $309.03 | Professional | None | $151.36 | $269.15 | $309.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,621.81 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $537.03 | Professional | None | $234.42 | $338.84 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $3,467.37 | Facility | None | $602.56 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $467.74 | Professional | None | $204.17 | $245.47 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $2,398.83 | Facility | None | $446.68 | $891.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $407.38 | Professional | None | $213.80 | $263.03 | $407.38 |
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 $177.83 Median $251.19 Typical High $446.68 | Professional | None | $177.83 | $251.19 | $446.68 |
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 $89.13 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 54 · Surgery only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $141.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $478.63 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $257.04 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $177.83 Typical High $257.04 | Professional | 51 · Multiple procedures | $117.49 | $177.83 | $257.04 |
Where North Carolina sits
The same service costs 8.1 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 $4,634MT $570
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.