How much rates vary
Facilitymedian $501 · 10th to 90th $309 to $1,995Professionalmedian $1,047 · 10th to 90th $513 to $1,660
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 $512.86 Typical High $7,413.10 | Facility | None | $478.63 | $512.86 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $831.76 | Professional | None | $478.63 | $512.86 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $1,047.13 | Facility | None | $263.03 | $407.38 | $1,047.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,819.70 | Professional | None | $891.25 | $1,318.26 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $512.86 Typical High $851.14 | Facility | None | $346.74 | $512.86 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,174.90 | Professional | None | $676.08 | $851.14 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $812.83 | Facility | None | $275.42 | $398.11 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $1,202.26 Typical High $1,258.93 | Professional | None | $489.78 | $1,202.26 | $1,258.93 |
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 $489.78 Median $912.01 Typical High $1,288.25 | Professional | None | $489.78 | $912.01 | $1,288.25 |
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 $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $354.81 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $380.19 Median $602.56 Typical High $1,023.29 | Facility | 50 · Both sides | $380.19 | $602.56 | $1,023.29 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $128.82 Median $199.53 Typical High $338.84 | Facility | 51 · Multiple procedures | $128.82 | $199.53 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,778.28 Typical High $1,905.46 | Professional | 50 · Both sides | $741.31 | $1,778.28 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $588.84 Typical High $630.96 | Professional | 51 · Multiple procedures | $245.47 | $588.84 | $630.96 |
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· 8th of 51
$1,000
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.