How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,023 to $8,710Professionalmedian $1,585 · 10th to 90th $977 to $2,754
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 $1,096.48 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,096.48 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,096.48 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,454.71 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $977.24 Median $2,511.89 Typical High $3,630.78 | Professional | None | $977.24 | $2,511.89 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,398.83 | Facility | None | $831.76 | $1,819.70 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,754.23 | $12,022.64 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,398.83 | Professional | None | $977.24 | $1,174.90 | $2,398.83 |
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 $549.54 Median $549.54 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,000.00 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,754.23 Typical High $5,248.07 | Facility | 50 · Both sides | $1,258.93 | $2,754.23 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $912.01 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $416.87 | $912.01 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,089.30 Typical High $2,187.76 | Professional | 50 · Both sides | $1,584.89 | $2,089.30 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $691.83 Typical High $724.44 | Professional | 51 · Multiple procedures | $537.03 | $691.83 | $724.44 |
Where North Carolina sits
The same service costs 3.8 times more in Wisconsin than in Delaware. 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
WI $11,217DE $2,968
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.