How much rates vary
Facilitymedian $389 · 10th to 90th $251 to $2,089Professionalmedian $676 · 10th to 90th $282 to $1,047
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 $263.03 Median $281.84 Typical High $10,000.00 | Facility | None | $263.03 | $281.84 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $758.58 | Professional | None | $263.03 | $281.84 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $562.34 Median $724.44 Typical High $1,230.27 | Professional | None | $562.34 | $724.44 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $630.96 | Facility | None | $213.80 | $331.13 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $851.14 | Professional | None | $380.19 | $575.44 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $467.74 | Facility | None | $251.19 | $389.05 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $1,174.90 | Professional | None | $398.11 | $741.31 | $1,174.90 |
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 $269.15 Median $645.65 Typical High $831.76 | Professional | None | $269.15 | $645.65 | $831.76 |
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 $131.83 Median $141.25 Typical High $169.82 | Professional | 52 · Reduced service | $131.83 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $194.98 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $239.88 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $380.19 Median $588.84 Typical High $691.83 | Facility | 50 · Both sides | $380.19 | $588.84 | $691.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $125.89 Median $194.98 Typical High $234.42 | Facility | 51 · Multiple procedures | $125.89 | $194.98 | $234.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $1,174.90 Typical High $1,819.70 | Professional | 50 · Both sides | $602.56 | $1,174.90 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $389.05 Typical High $602.56 | Professional | 51 · Multiple procedures | $199.53 | $389.05 | $602.56 |
Where North Carolina sits
The same service costs 5.0 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· 6th of 51
$661
AK $1,096UT $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.