How much rates vary
Facilitymedian $1,622 · 10th to 90th $537 to $4,677Professionalmedian $537 · 10th to 90th $407 to $1,349
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 $537.03 Median $1,000.00 Typical High $7,943.28 | Facility | None | $537.03 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | None | $537.03 | $537.03 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $1,737.80 | Professional | None | $407.38 | $489.78 | $1,737.80 |
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 $407.38 Median $467.74 Typical High $1,047.13 | Professional | None | $407.38 | $467.74 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $851.14 Typical High $1,862.09 | Facility | None | $380.19 | $851.14 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $776.25 | Professional | None | $524.81 | $549.54 | $776.25 |
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 $436.52 Median $524.81 Typical High $1,096.48 | Professional | None | $436.52 | $524.81 | $1,096.48 |
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 $269.15 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $478.63 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,318.26 Typical High $3,890.45 | Facility | 50 · Both sides | $562.34 | $1,318.26 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $446.68 Typical High $1,318.26 | Facility | 51 · Multiple procedures | $186.21 | $446.68 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $831.76 Typical High $1,174.90 | Professional | 50 · Both sides | $776.25 | $831.76 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $275.42 Typical High $389.05 | Professional | 51 · Multiple procedures | $257.04 | $275.42 | $389.05 |
Where North Carolina sits
The same service costs 8.3 times more in Wyoming than in Texas. 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· 37th of 51
$589
WY $2,512TX $302
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.