How much rates vary
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 $181.97 Median $245.47 Typical High $7,413.10 | Facility | None | $181.97 | $245.47 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $295.12 | Professional | None | $181.97 | $234.42 | $295.12 |
BCBS 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 Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $501.19 | Professional | None | $239.88 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,344.23 Typical High $3,467.37 | Facility | None | $457.09 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $524.81 | Professional | None | $199.53 | $251.19 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $2,398.83 | Facility | None | $295.12 | $549.54 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $398.11 | Professional | None | $239.88 | $295.12 | $398.11 |
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 $263.03 Typical High $524.81 | Professional | None | $177.83 | $263.03 | $524.81 |
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 $91.20 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $138.04 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $169.82 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $446.68 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $186.21 | $446.68 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $158.49 Typical High $309.03 | Professional | 51 · Multiple procedures | $120.23 | $158.49 | $309.03 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in Utah. 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.
North Carolina· 17th of 51
$331
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.