How much rates vary
Facilitymedian $525 · 10th to 90th $295 to $1,862Professionalmedian $324 · 10th to 90th $219 to $813
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 $295.12 Median $323.59 Typical High $7,585.78 | Facility | None | $295.12 | $323.59 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $512.86 | Professional | None | $295.12 | $323.59 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $407.38 | Professional | None | $223.87 | $323.59 | $407.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $1,174.90 | Facility | None | $295.12 | $457.09 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $977.24 | Professional | None | $218.78 | $323.59 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,737.80 | Facility | None | $363.08 | $562.34 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $602.56 | Professional | None | $239.88 | $281.84 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $954.99 | Facility | None | $269.15 | $478.63 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $776.25 | Professional | None | $302.00 | $380.19 | $776.25 |
Oscar Health Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $794.33 | Facility | None | $338.84 | $338.84 | $794.33 |
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 $263.03 Median $323.59 Typical High $645.65 | Professional | None | $263.03 | $323.59 | $645.65 |
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 $147.91 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $147.91 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $269.15 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $380.19 Median $776.25 Typical High $1,445.44 | Facility | 50 · Both sides | $380.19 | $776.25 | $1,445.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $125.89 Median $257.04 Typical High $478.63 | Facility | 51 · Multiple procedures | $125.89 | $257.04 | $478.63 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $562.34 Typical High $1,479.11 | Professional | 50 · Both sides | $457.09 | $562.34 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $190.55 Typical High $489.78 | Professional | 51 · Multiple procedures | $151.36 | $190.55 | $489.78 |
Where North Carolina sits
The same service costs 5.8 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· 41st of 51
$324
AK $1,259UT $219
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.