How much rates vary
Facilitymedian $1,820 · 10th to 90th $631 to $5,754Professionalmedian $692 · 10th to 90th $417 to $1,202
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 $478.63 Median $1,148.15 Typical High $7,943.28 | Facility | None | $478.63 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $794.33 | Professional | None | $478.63 | $478.63 | $794.33 |
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 $416.87 Median $851.14 Typical High $1,584.89 | Professional | None | $416.87 | $851.14 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $4,365.16 | Facility | None | $602.56 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $954.99 | Professional | None | $389.05 | $446.68 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $3,388.44 | Facility | None | $524.81 | $891.25 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $724.44 | Professional | None | $467.74 | $562.34 | $724.44 |
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 $416.87 Median $489.78 Typical High $1,023.29 | Professional | None | $416.87 | $489.78 | $1,023.29 |
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 $239.88 Median $239.88 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $467.74 | Professional | 54 · Surgery only | $354.81 | $354.81 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,412.54 Typical High $7,079.46 | Facility | 50 · Both sides | $776.25 | $1,412.54 | $7,079.46 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $478.63 Typical High $2,344.23 | Facility | 51 · Multiple procedures | $263.03 | $478.63 | $2,344.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $851.14 Typical High $1,096.48 | Professional | 50 · Both sides | $691.83 | $851.14 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $281.84 Typical High $363.08 | Professional | 51 · Multiple procedures | $234.42 | $281.84 | $363.08 |
Where North Carolina sits
The same service costs 7.9 times more in Wyoming 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· 17th of 51
$813
WY $2,344UT $295
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.