How much rates vary
Facilitymedian $1,380 · 10th to 90th $513 to $4,898Professionalmedian $676 · 10th to 90th $562 to $1,738
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 $676.08 Median $1,288.25 Typical High $10,471.29 | Facility | None | $676.08 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $977.24 | Professional | None | $676.08 | $676.08 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $380.19 Median $562.34 Typical High $776.25 | Facility | None | $380.19 | $562.34 | $776.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $2,238.72 | Professional | None | $562.34 | $660.69 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $2,818.38 | Facility | None | $794.33 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,348.96 | Professional | None | $562.34 | $676.08 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $912.01 Typical High $2,290.87 | Facility | None | $436.52 | $912.01 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,479.11 | Professional | None | $588.84 | $724.44 | $1,479.11 |
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 $338.84 Median $338.84 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $616.60 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $616.60 Median $1,348.96 Typical High $3,890.45 | Facility | 50 · Both sides | $616.60 | $1,348.96 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $204.17 Median $457.09 Typical High $1,318.26 | Facility | 51 · Multiple procedures | $204.17 | $457.09 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,071.52 Typical High $1,513.56 | Professional | 50 · Both sides | $1,000.00 | $1,071.52 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $363.08 Typical High $501.19 | Professional | 51 · Multiple procedures | $331.13 | $363.08 | $501.19 |
Where North Carolina sits
The same service costs 4.0 times more in Alaska than in Alabama. 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
AK $6,054AL $1,518
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.