How much rates vary
Facilitymedian $1,778 · 10th to 90th $646 to $4,074Professionalmedian $427 · 10th to 90th $138 to $955
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 $281.84 Median $436.52 Typical High $5,248.07 | Facility | None | $281.84 | $436.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $467.74 | Professional | None | $281.84 | $436.52 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,445.44 | $2,137.96 | $2,951.21 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $426.58 Typical High $1,096.48 | Professional | None | $138.04 | $426.58 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,630.27 | Facility | None | $891.25 | $1,621.81 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $724.44 | Professional | None | $234.42 | $407.38 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $1,513.56 Typical High $1,819.70 | Facility | None | $489.78 | $1,513.56 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $524.81 | Professional | None | $281.84 | $426.58 | $524.81 |
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 $275.42 Median $407.38 Typical High $707.95 | Professional | None | $275.42 | $407.38 | $707.95 |
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 $141.25 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $141.25 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $56.23 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $208.93 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $309.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,737.80 Median $2,754.23 Typical High $3,235.94 | Facility | 50 · Both sides | $1,737.80 | $2,754.23 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $588.84 Median $912.01 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $588.84 | $912.01 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $645.65 Typical High $851.14 | Professional | 50 · Both sides | $416.87 | $645.65 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $213.80 Typical High $281.84 | Professional | 51 · Multiple procedures | $141.25 | $213.80 | $281.84 |
Where North Carolina sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 36th of 51
$437
AK $1,585UT $288
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.