How much rates vary
Facilitymedian $1,288 · 10th to 90th $372 to $3,715Professionalmedian $200 · 10th to 90th $126 to $417
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 $125.89 Median $190.55 Typical High $7,413.10 | Facility | None | $125.89 | $190.55 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $309.03 | Professional | None | $125.89 | $190.55 | $309.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $3,630.78 | Facility | None | $912.01 | $1,412.54 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $478.63 | Professional | None | $138.04 | $199.53 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,698.24 Typical High $2,511.89 | Facility | None | $457.09 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $302.00 | Professional | None | $107.15 | $158.49 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $549.54 Typical High $1,862.09 | Facility | None | $199.53 | $549.54 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $234.42 | Professional | None | $181.97 | $186.21 | $234.42 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $316.23 | Professional | None | $123.03 | $173.78 | $316.23 |
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 $63.10 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $63.10 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $25.12 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $134.90 Typical High $141.25 | Professional | 54 · Surgery only | $93.33 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.59 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $125.89 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $87.10 | $125.89 | $131.83 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,047.13 Typical High $3,890.45 | Facility | 50 · Both sides | $562.34 | $1,047.13 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $346.74 Typical High $1,318.26 | Facility | 51 · Multiple procedures | $186.21 | $346.74 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $281.84 Typical High $371.54 | Professional | 50 · Both sides | $275.42 | $281.84 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $93.33 Typical High $123.03 | Professional | 51 · Multiple procedures | $91.20 | $93.33 | $123.03 |
Where North Carolina sits
The same service costs 4.7 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· 35th of 51
$200
AK $708UT $151
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.