How much rates vary
Facilitymedian $148 · 10th to 90th $95 to $955Professionalmedian $219 · 10th to 90th $132 to $389
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 $114.82 Median $131.83 Typical High $7,413.10 | Facility | None | $114.82 | $131.83 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $234.42 | Professional | None | $114.82 | $131.83 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Professional | None | $112.20 | $165.96 | $223.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $83.18 Median $125.89 Typical High $331.13 | Facility | None | $83.18 | $125.89 | $331.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $398.11 | Professional | None | $177.83 | $263.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $524.81 | Facility | None | $102.33 | $158.49 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $331.13 | Professional | None | $144.54 | $186.21 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | None | $275.42 | $275.42 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $208.93 | Facility | None | $89.13 | $128.82 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $269.15 | Professional | None | $154.88 | $204.17 | $269.15 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $302.00 | Professional | None | $104.71 | $158.49 | $302.00 |
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 $57.54 Median $66.07 Typical High $69.18 | Professional | 52 · Reduced service | $57.54 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $22.91 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $100.00 Typical High $104.71 | Professional | 54 · Surgery only | $85.11 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $20.89 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $93.33 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $79.43 | $93.33 | $97.72 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $125.89 Median $194.98 Typical High $309.03 | Facility | 50 · Both sides | $125.89 | $194.98 | $309.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $41.69 Median $64.57 Typical High $102.33 | Facility | 51 · Multiple procedures | $41.69 | $64.57 | $102.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $316.23 Typical High $537.03 | Professional | 50 · Both sides | $275.42 | $316.23 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $104.71 Typical High $177.83 | Professional | 51 · Multiple procedures | $91.20 | $104.71 | $177.83 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 11th of 51
$219
AK $490FL $117
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.