How much rates vary
Facilitymedian $1,288 · 10th to 90th $380 to $3,311Professionalmedian $162 · 10th to 90th $107 to $347
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 $107.15 Median $169.82 Typical High $7,413.10 | Facility | None | $107.15 | $169.82 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $245.47 | Professional | None | $107.15 | $169.82 | $245.47 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,778.28 | Facility | None | $891.25 | $1,318.26 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $426.58 | Professional | None | $109.65 | $162.18 | $426.58 |
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 $89.13 Median $141.25 Typical High $269.15 | Professional | None | $89.13 | $141.25 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $537.03 Typical High $1,862.09 | Facility | None | $169.82 | $537.03 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $199.53 | Professional | None | $107.15 | $162.18 | $199.53 |
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 $104.71 Median $151.36 Typical High $269.15 | Professional | None | $104.71 | $151.36 | $269.15 |
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 $52.48 Median $77.62 Typical High $85.11 | Professional | 52 · Reduced service | $52.48 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $21.38 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $114.82 Typical High $128.82 | Professional | 54 · Surgery only | $79.43 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.91 Typical High $25.70 | Professional | 55 · Aftercare only | $15.85 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $107.15 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $74.13 | $107.15 | $120.23 |
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 $162.18 Median $245.47 Typical High $309.03 | Professional | 50 · Both sides | $162.18 | $245.47 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $81.28 Typical High $102.33 | Professional | 51 · Multiple procedures | $53.70 | $81.28 | $102.33 |
Where North Carolina sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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
$170
AK $603KY $126
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.