How much rates vary
Facilitymedian $1,096 · 10th to 90th $437 to $4,677Professionalmedian $603 · 10th to 90th $302 to $1,023
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 $186.21 Median $436.52 Typical High $5,495.41 | Facility | None | $186.21 | $436.52 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $436.52 Typical High $645.65 | Professional | None | $186.21 | $436.52 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
BCBS North Carolina Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $794.33 | Facility | None | $398.11 | $588.84 | $794.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $338.84 Median $758.58 Typical High $1,047.13 | Professional | None | $338.84 | $758.58 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $2,238.72 | Facility | None | $524.81 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $794.33 | Professional | None | $302.00 | $501.19 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $537.03 Typical High $1,621.81 | Facility | None | $346.74 | $537.03 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $707.95 | Professional | None | $489.78 | $602.56 | $707.95 |
Oscar Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $8,511.38 | Facility | None | $1,071.52 | $1,071.52 | $8,511.38 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $776.25 | Professional | None | $208.93 | $407.38 | $776.25 |
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 $93.33 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $93.33 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $37.15 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $141.25 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $28.18 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $18.62 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $131.83 | $257.04 | $302.00 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $524.81 Median $812.83 Typical High $3,162.28 | Facility | 50 · Both sides | $524.81 | $812.83 | $3,162.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $173.78 Median $269.15 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $173.78 | $269.15 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $891.25 Typical High $1,548.82 | Professional | 50 · Both sides | $870.96 | $891.25 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $295.12 Typical High $512.86 | Professional | 51 · Multiple procedures | $295.12 | $295.12 | $512.86 |
Where North Carolina sits
The same service costs 4.6 times more in Colorado than in Montana. 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 $4,728MT $1,029
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.