How much rates vary
Facilitymedian $1,514 · 10th to 90th $676 to $4,571Professionalmedian $617 · 10th to 90th $417 to $1,318
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 $416.87 Median $537.03 Typical High $8,511.38 | Facility | None | $416.87 | $537.03 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $758.58 | Professional | None | $416.87 | $537.03 | $758.58 |
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 $436.52 Median $1,047.13 Typical High $1,380.38 | Professional | None | $436.52 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $2,570.40 | Facility | None | $794.33 | $1,819.70 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $933.25 | Professional | None | $363.08 | $457.09 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $891.25 Typical High $2,089.30 | Facility | None | $645.65 | $891.25 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $758.58 | Professional | None | $512.86 | $724.44 | $758.58 |
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 $407.38 Median $524.81 Typical High $1,000.00 | Professional | None | $407.38 | $524.81 | $1,000.00 |
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 $208.93 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $371.54 | $426.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,479.11 Typical High $3,235.94 | Facility | 50 · Both sides | $1,096.48 | $1,479.11 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $363.08 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,096.48 Typical High $1,380.38 | Professional | 50 · Both sides | $776.25 | $1,096.48 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $363.08 Typical High $457.09 | Professional | 51 · Multiple procedures | $257.04 | $363.08 | $457.09 |
Where North Carolina sits
The same service costs 6.5 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· 25th of 51
$661
AK $2,239UT $347
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.