How much rates vary
Facilitymedian $1,995 · 10th to 90th $851 to $6,310Professionalmedian $513 · 10th to 90th $457 to $1,230
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 $489.78 Median $1,445.44 Typical High $10,715.19 | Facility | None | $489.78 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $812.83 | Professional | None | $489.78 | $489.78 | $812.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $2,137.96 | Facility | None | $1,047.13 | $1,584.89 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $1,584.89 | Professional | None | $457.09 | $489.78 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,467.37 | Facility | None | $912.01 | $2,818.38 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $933.25 | Professional | None | $416.87 | $537.03 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $977.24 Typical High $2,398.83 | Facility | None | $812.83 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $776.25 | Professional | None | $467.74 | $741.31 | $776.25 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $1,047.13 | Professional | None | $426.58 | $524.81 | $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 $239.88 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | 54 · Surgery only | $363.08 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $5,248.07 | Facility | 50 · Both sides | $1,258.93 | $1,479.11 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $489.78 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $416.87 | $489.78 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,174.90 Typical High $1,348.96 | Professional | 50 · Both sides | $707.95 | $1,174.90 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $389.05 Typical High $457.09 | Professional | 51 · Multiple procedures | $234.42 | $389.05 | $457.09 |
Where North Carolina sits
The same service costs 7.9 times more in Wyoming 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· 40th of 51
$550
WY $2,399UT $302
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.