How much rates vary
Facilitymedian $1,660 · 10th to 90th $295 to $5,248Professionalmedian $363 · 10th to 90th $240 to $692
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 $229.09 Median $295.12 Typical High $2,041.74 | Facility | None | $229.09 | $295.12 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $398.11 | Professional | None | $229.09 | $295.12 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $398.11 | Professional | None | $190.55 | $190.55 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,778.28 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $707.95 | Professional | None | $295.12 | $478.63 | $707.95 |
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 $239.88 Median $309.03 Typical High $645.65 | Professional | None | $239.88 | $309.03 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $891.25 Typical High $2,398.83 | Facility | None | $354.81 | $891.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $489.78 | Professional | None | $316.23 | $363.08 | $489.78 |
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 $223.87 Median $323.59 Typical High $645.65 | Professional | None | $223.87 | $323.59 | $645.65 |
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 $114.82 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $173.78 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $162.18 | $186.21 | $204.17 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $489.78 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $257.04 | $489.78 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $181.97 Typical High $398.11 | Professional | 51 · Multiple procedures | $158.49 | $181.97 | $398.11 |
Where North Carolina sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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 $5,029WV $590
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.