How much rates vary
Facilitymedian $1,349 · 10th to 90th $468 to $5,129Professionalmedian $1,047 · 10th to 90th $525 to $1,778
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 $467.74 Median $776.25 Typical High $7,413.10 | Facility | None | $467.74 | $776.25 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $851.14 | Professional | None | $467.74 | $691.83 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,949.84 | Professional | None | $691.83 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,905.46 | Facility | None | $457.09 | $1,348.96 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,513.56 | Professional | None | $512.86 | $741.31 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,096.48 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $831.76 Typical High $1,905.46 | Facility | None | $380.19 | $831.76 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,202.26 | Professional | None | $549.54 | $851.14 | $1,202.26 |
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 $446.68 Median $724.44 Typical High $1,479.11 | Professional | None | $446.68 | $724.44 | $1,479.11 |
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 $234.42 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $234.42 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $93.33 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $354.81 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $70.79 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $46.77 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $331.13 | $478.63 | $549.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,230.27 Typical High $3,162.28 | Facility | 50 · Both sides | $562.34 | $1,230.27 | $3,162.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $416.87 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $186.21 | $416.87 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,288.25 Typical High $2,630.27 | Professional | 50 · Both sides | $812.83 | $1,288.25 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $426.58 Typical High $870.96 | Professional | 51 · Multiple procedures | $269.15 | $426.58 | $870.96 |
Where North Carolina sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.