How much rates vary
Facilitymedian $871 · 10th to 90th $380 to $7,244Professionalmedian $1,585 · 10th to 90th $871 to $2,188
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 $870.96 Median $870.96 Typical High $7,943.28 | Facility | None | $870.96 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | None | $870.96 | $870.96 | $1,047.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,905.46 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,344.23 | Professional | None | $831.76 | $1,148.15 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $2,951.21 | Facility | None | $870.96 | $1,047.13 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,445.44 | Professional | None | $891.25 | $1,071.52 | $1,445.44 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,187.76 | Professional | None | $831.76 | $1,148.15 | $2,187.76 |
7 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 $436.52 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $537.03 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $446.68 | $537.03 | $1,258.93 |
Where North Carolina sits
The same service costs 10.1 times more in Maine than in Arkansas. 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
ME $16,050AR $1,584
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.