How much rates vary
Facilitymedian $537 · 10th to 90th $309 to $1,862Professionalmedian $372 · 10th to 90th $309 to $933
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 $338.84 Median $371.54 Typical High $7,585.78 | Facility | None | $338.84 | $371.54 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $478.63 | Professional | None | $338.84 | $371.54 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $331.13 Median $407.38 Typical High $1,122.02 | Professional | None | $331.13 | $407.38 | $1,122.02 |
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 $275.42 Median $323.59 Typical High $707.95 | Professional | None | $275.42 | $323.59 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $512.86 Typical High $954.99 | Facility | None | $269.15 | $512.86 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $891.25 | Professional | None | $363.08 | $371.54 | $891.25 |
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 $309.03 Median $389.05 Typical High $741.31 | Professional | None | $309.03 | $389.05 | $741.31 |
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 $169.82 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $169.82 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $67.61 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $257.04 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $309.03 |
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 $549.54 Median $549.54 Typical High $1,412.54 | Professional | 50 · Both sides | $549.54 | $549.54 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $186.21 Typical High $467.74 | Professional | 51 · Multiple procedures | $181.97 | $186.21 | $467.74 |
Where North Carolina sits
The same service costs 5.6 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· 39th of 51
$389
AK $1,413UT $251
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.