How much rates vary
Facilitymedian $2,188 · 10th to 90th $832 to $6,026Professionalmedian $776 · 10th to 90th $603 to $2,089
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 $831.76 Median $1,288.25 Typical High $8,317.64 | Facility | None | $831.76 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,174.90 | Professional | None | $831.76 | $831.76 | $1,174.90 |
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 $602.56 Median $691.83 Typical High $2,454.71 | Professional | None | $602.56 | $691.83 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,344.23 Typical High $3,467.37 | Facility | None | $645.65 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,513.56 | Professional | None | $602.56 | $724.44 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $2,454.71 | Facility | None | $602.56 | $1,174.90 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $933.25 | Professional | None | $794.33 | $870.96 | $933.25 |
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 $616.60 Median $776.25 Typical High $1,513.56 | Professional | None | $616.60 | $776.25 | $1,513.56 |
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 $416.87 Median $416.87 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 53 · Discontinued | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $724.44 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,737.80 Typical High $5,248.07 | Facility | 50 · Both sides | $891.25 | $1,737.80 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $588.84 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $295.12 | $588.84 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,318.26 Typical High $1,412.54 | Professional | 50 · Both sides | $1,202.26 | $1,318.26 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | 51 · Multiple procedures | $398.11 | $436.52 | $467.74 |
Where North Carolina sits
The same service costs 8.3 times more in Wyoming 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· 39th of 51
$871
WY $4,074UT $490
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.