How much rates vary
Facilitymedian $214 · 10th to 90th $110 to $871Professionalmedian $275 · 10th to 90th $195 to $589
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 $208.93 Median $234.42 Typical High $7,413.10 | Facility | None | $208.93 | $234.42 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $295.12 | Professional | None | $208.93 | $234.42 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $109.65 Median $162.18 Typical High $223.87 | Facility | None | $109.65 | $162.18 | $223.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $676.08 | Professional | None | $204.17 | $275.42 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $524.81 | Facility | None | $162.18 | $251.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $436.52 | Professional | None | $173.78 | $223.87 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $371.54 | Facility | None | $151.36 | $218.78 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $346.74 | Professional | None | $223.87 | $316.23 | $346.74 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $489.78 | Professional | None | $194.98 | $245.47 | $489.78 |
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 $104.71 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $190.55 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $208.93 Median $323.59 Typical High $512.86 | Facility | 50 · Both sides | $208.93 | $323.59 | $512.86 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $70.79 Median $109.65 Typical High $169.82 | Facility | 51 · Multiple procedures | $70.79 | $109.65 | $169.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $478.63 Typical High $524.81 | Professional | 50 · Both sides | $338.84 | $478.63 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $158.49 Typical High $173.78 | Professional | 51 · Multiple procedures | $112.20 | $158.49 | $173.78 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 34th of 51
$269
AK $871FL $204
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.