How much rates vary
Facilitymedian $1,514 · 10th to 90th $575 to $4,571Professionalmedian $417 · 10th to 90th $282 to $977
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 $295.12 Median $467.74 Typical High $7,943.28 | Facility | None | $295.12 | $467.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $660.69 | Professional | None | $295.12 | $467.74 | $660.69 |
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 $295.12 Median $416.87 Typical High $1,148.15 | Professional | None | $295.12 | $416.87 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $2,187.76 | Facility | None | $645.65 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $691.83 | Professional | None | $218.78 | $323.59 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $1,698.24 | Facility | None | $478.63 | $851.14 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $741.31 | Professional | None | $436.52 | $524.81 | $741.31 |
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 $269.15 Median $389.05 Typical High $758.58 | Professional | None | $269.15 | $389.05 | $758.58 |
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 $147.91 Median $213.80 Typical High $234.42 | Professional | 52 · Reduced service | $147.91 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $58.88 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $44.67 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $29.51 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $323.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,348.96 Typical High $3,235.94 | Facility | 50 · Both sides | $891.25 | $1,348.96 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $446.68 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $446.68 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $812.83 Typical High $1,122.02 | Professional | 50 · Both sides | $645.65 | $812.83 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $275.42 Typical High $371.54 | Professional | 51 · Multiple procedures | $218.78 | $275.42 | $371.54 |
Where North Carolina sits
The same service costs 5.9 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· 39th of 51
$437
AK $1,698UT $288
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.