How much rates vary
Facilitymedian $1,514 · 10th to 90th $537 to $4,365Professionalmedian $355 · 10th to 90th $288 to $891
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 $354.81 Median $489.78 Typical High $7,585.78 | Facility | None | $354.81 | $489.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $588.84 | Professional | None | $354.81 | $354.81 | $588.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,137.96 | Facility | None | $1,047.13 | $1,548.82 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $1,148.15 | Professional | None | $269.15 | $338.84 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,137.96 | Facility | None | $602.56 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $691.83 | Professional | None | $288.40 | $338.84 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,513.56 | Facility | None | $512.86 | $851.14 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $457.09 | Professional | None | $309.03 | $398.11 | $457.09 |
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 $309.03 Median $363.08 Typical High $758.58 | Professional | None | $309.03 | $363.08 | $758.58 |
8 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 $177.83 Median $177.83 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $316.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $257.04 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $199.53 Typical High $239.88 | Professional | 51 · Multiple procedures | $169.82 | $199.53 | $239.88 |
Where North Carolina sits
The same service costs 4.5 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,914MT $1,099
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.