How much rates vary
Facilitymedian $490 · 10th to 90th $302 to $2,089Professionalmedian $741 · 10th to 90th $490 to $1,288
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 $489.78 Typical High $10,000.00 | Facility | None | $478.63 | $489.78 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $977.24 | Professional | None | $478.63 | $489.78 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $588.84 | Professional | None | $489.78 | $537.03 | $588.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $1,071.52 | Facility | None | $269.15 | $416.87 | $1,071.52 |
BCBS North Carolina Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,548.82 | Professional | None | $630.96 | $741.31 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $851.14 | Facility | None | $346.74 | $501.19 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,000.00 | Professional | None | $537.03 | $660.69 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $794.33 | Facility | None | $269.15 | $389.05 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,148.15 | Professional | None | $478.63 | $794.33 | $1,148.15 |
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 $478.63 Median $676.08 Typical High $1,047.13 | Professional | None | $478.63 | $676.08 | $1,047.13 |
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 $245.47 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $354.81 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $380.19 Median $588.84 Typical High $1,023.29 | Facility | 50 · Both sides | $380.19 | $588.84 | $1,023.29 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $125.89 Median $194.98 Typical High $338.84 | Facility | 51 · Multiple procedures | $125.89 | $194.98 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,230.27 Typical High $1,778.28 | Professional | 50 · Both sides | $724.44 | $1,230.27 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $407.38 Typical High $588.84 | Professional | 51 · Multiple procedures | $239.88 | $407.38 | $588.84 |
Where North Carolina sits
The same service costs 6.2 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· 19th of 51
$741
AK $1,995UT $324
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.