How much rates vary
Facilitymedian $1,549 · 10th to 90th $692 to $5,248Professionalmedian $550 · 10th to 90th $501 to $1,380
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 $549.54 Median $1,288.25 Typical High $10,471.29 | Facility | None | $549.54 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $794.33 | Professional | None | $549.54 | $549.54 | $794.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,630.78 | Facility | None | $912.01 | $1,380.38 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $1,778.28 | Professional | None | $501.19 | $512.86 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $2,570.40 | Facility | None | $794.33 | $1,819.70 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $1,071.52 | Professional | None | $436.52 | $524.81 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $891.25 Typical High $2,041.74 | Facility | None | $691.83 | $891.25 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $870.96 | Professional | None | $537.03 | $676.08 | $870.96 |
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 $457.09 Median $562.34 Typical High $1,174.90 | Professional | None | $457.09 | $562.34 | $1,174.90 |
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 $275.42 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $501.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,047.13 Median $1,348.96 Typical High $3,235.94 | Facility | 50 · Both sides | $1,047.13 | $1,348.96 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $346.74 Median $446.68 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $346.74 | $446.68 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $1,348.96 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $338.84 Typical High $446.68 | Professional | 51 · Multiple procedures | $269.15 | $338.84 | $446.68 |
Where North Carolina sits
The same service costs 8.5 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· 44th of 51
$575
WY $2,512UT $295
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.