How much rates vary
Facilitymedian $372 · 10th to 90th $234 to $1,905Professionalmedian $417 · 10th to 90th $263 to $741
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 $229.09 Median $288.40 Typical High $7,413.10 | Facility | None | $229.09 | $288.40 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $537.03 | Professional | None | $229.09 | $288.40 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $371.54 | Professional | None | $194.98 | $281.84 | $371.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $741.31 | Facility | None | $186.21 | $288.40 | $741.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $870.96 | Professional | None | $338.84 | $426.58 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $645.65 | Facility | None | $229.09 | $363.08 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $562.34 | Professional | None | $323.59 | $363.08 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $512.86 | Facility | None | $223.87 | $323.59 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $776.25 | Professional | None | $407.38 | $457.09 | $776.25 |
Oscar Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $1,000.00 | Facility | None | $218.78 | $218.78 | $1,000.00 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $575.44 | Professional | None | $229.09 | $398.11 | $575.44 |
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 $112.20 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $112.20 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $45.71 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $169.82 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.91 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $158.49 | $199.53 | $229.09 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $316.23 Median $489.78 Typical High $758.58 | Facility | 50 · Both sides | $316.23 | $489.78 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $104.71 Median $162.18 Typical High $257.04 | Facility | 51 · Multiple procedures | $104.71 | $162.18 | $257.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $691.83 Typical High $1,258.93 | Professional | 50 · Both sides | $602.56 | $691.83 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $229.09 Typical High $416.87 | Professional | 51 · Multiple procedures | $204.17 | $229.09 | $416.87 |
Where North Carolina sits
The same service costs 4.2 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· 15th of 51
$417
AK $955UT $229
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.