How much rates vary
Facilitymedian $380 · 10th to 90th $214 to $2,239Professionalmedian $224 · 10th to 90th $93 to $501
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 $93.33 Median $239.88 Typical High $7,413.10 | Facility | None | $93.33 | $239.88 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $223.87 Typical High $295.12 | Professional | None | $93.33 | $223.87 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $169.82 Median $251.19 Typical High $338.84 | Facility | None | $169.82 | $251.19 | $338.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $575.44 | Professional | None | $100.00 | $223.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $645.65 | Facility | None | $239.88 | $363.08 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $208.93 Typical High $346.74 | Professional | None | $77.62 | $208.93 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $524.81 | Facility | None | $213.80 | $331.13 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $407.38 | Professional | None | $120.23 | $275.42 | $407.38 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $91.20 Median $190.55 Typical High $323.59 | Professional | None | $91.20 | $190.55 | $323.59 |
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 $46.77 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $46.77 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $39.81 Typical High $47.86 | Professional | 53 · Discontinued | $18.62 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $69.18 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $14.13 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $9.33 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $138.04 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $64.57 | $138.04 | $165.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $316.23 Median $489.78 Typical High $776.25 | Facility | 50 · Both sides | $316.23 | $489.78 | $776.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $104.71 Median $165.96 Typical High $263.03 | Facility | 51 · Multiple procedures | $104.71 | $165.96 | $263.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $446.68 Typical High $602.56 | Professional | 50 · Both sides | $181.97 | $446.68 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $147.91 Typical High $199.53 | Professional | 51 · Multiple procedures | $60.26 | $147.91 | $199.53 |
Where North Carolina sits
The same service costs 5.6 times more in Alaska than in Kentucky. 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· 28th of 51
$224
AK $562KY $100
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.