How much rates vary
Facilitymedian $2,455 · 10th to 90th $851 to $6,026Professionalmedian $851 · 10th to 90th $631 to $2,239
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 $912.01 Median $1,288.25 Typical High $8,317.64 | Facility | None | $912.01 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | None | $912.01 | $912.01 | $1,258.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $2,137.96 | $3,235.94 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $2,691.53 | Professional | None | $630.96 | $776.25 | $2,691.53 |
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 $660.69 Median $794.33 Typical High $1,737.80 | Professional | None | $660.69 | $794.33 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $2,511.89 | Facility | None | $602.56 | $1,445.44 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | None | $831.76 | $933.25 | $1,023.29 |
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 $676.08 Median $851.14 Typical High $1,659.59 | Professional | None | $676.08 | $851.14 | $1,659.59 |
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 $457.09 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $794.33 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,630.27 Typical High $5,248.07 | Facility | 50 · Both sides | $891.25 | $2,630.27 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $870.96 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $295.12 | $870.96 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,412.54 Typical High $1,513.56 | Professional | 50 · Both sides | $1,258.93 | $1,412.54 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 51 · Multiple procedures | $416.87 | $467.74 | $501.19 |
Where North Carolina sits
The same service costs 8.1 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· 42nd of 51
$912
WY $4,169UT $513
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.