How much rates vary
Facilitymedian $562 · 10th to 90th $295 to $5,248Professionalmedian $309 · 10th to 90th $209 to $759
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 $190.55 Median $309.03 Typical High $7,943.28 | Facility | None | $190.55 | $309.03 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $380.19 | Professional | None | $190.55 | $309.03 | $380.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $851.14 | Facility | None | $213.80 | $331.13 | $851.14 |
BCBS North Carolina Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $776.25 | Professional | None | $245.47 | $354.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $707.95 | Facility | None | $288.40 | $416.87 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $575.44 | Professional | None | $208.93 | $309.03 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $616.60 | Facility | None | $263.03 | $407.38 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $676.08 | Professional | None | $269.15 | $407.38 | $676.08 |
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 $190.55 Median $302.00 Typical High $501.19 | Professional | None | $190.55 | $302.00 | $501.19 |
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 $95.50 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $213.80 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $389.05 Median $616.60 Typical High $912.01 | Facility | 50 · Both sides | $389.05 | $616.60 | $912.01 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $131.83 Median $204.17 Typical High $309.03 | Facility | 51 · Multiple procedures | $131.83 | $204.17 | $309.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $741.31 Typical High $1,023.29 | Professional | 50 · Both sides | $407.38 | $741.31 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $251.19 Typical High $338.84 | Professional | 51 · Multiple procedures | $134.90 | $251.19 | $338.84 |
Where North Carolina sits
The same service costs 4.3 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· 26th of 51
$347
WY $933UT $219
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.