How much rates vary
Facilitymedian $1,698 · 10th to 90th $741 to $7,244Professionalmedian $1,047 · 10th to 90th $724 to $1,950
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 $676.08 Median $812.83 Typical High $10,471.29 | Facility | None | $676.08 | $812.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,122.02 | Professional | None | $676.08 | $676.08 | $1,122.02 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $7,762.47 | Facility | None | $1,949.84 | $3,090.30 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,041.74 | Professional | None | $912.01 | $1,230.27 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $2,570.40 | Facility | None | $794.33 | $1,584.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,698.24 | Professional | None | $758.58 | $776.25 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $3,019.95 | Facility | None | $724.44 | $1,202.26 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,122.02 | Professional | None | $758.58 | $831.76 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,698.24 | Professional | None | $575.44 | $794.33 | $1,698.24 |
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 $338.84 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $562.34 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $7,762.47 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $7,762.47 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,258.93 Typical High $2,511.89 | Professional | 50 · Both sides | $1,122.02 | $1,258.93 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $416.87 Typical High $831.76 | Professional | 51 · Multiple procedures | $371.54 | $416.87 | $831.76 |
Where North Carolina sits
The same service costs 4.1 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 $8,541MD $2,072
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.