How much rates vary
Facilitymedian $603 · 10th to 90th $282 to $5,248Professionalmedian $324 · 10th to 90th $204 to $724
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 $295.12 Typical High $7,943.28 | Facility | None | $190.55 | $295.12 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $371.54 | Professional | None | $190.55 | $295.12 | $371.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $812.83 | Facility | None | $204.17 | $316.23 | $812.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $758.58 | Professional | None | $234.42 | $338.84 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $776.25 | Facility | None | $281.84 | $436.52 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $549.54 | Professional | None | $204.17 | $302.00 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $398.11 Typical High $602.56 | Facility | None | $257.04 | $398.11 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $676.08 | Professional | None | $257.04 | $398.11 | $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 $295.12 Typical High $501.19 | Professional | None | $190.55 | $295.12 | $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 $147.91 | Professional | 52 · Reduced service | $95.50 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $38.02 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $141.25 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $194.98 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $131.83 | $194.98 | $208.93 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $389.05 Median $602.56 Typical High $891.25 | Facility | 50 · Both sides | $389.05 | $602.56 | $891.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $128.82 Median $199.53 Typical High $302.00 | Facility | 51 · Multiple procedures | $128.82 | $199.53 | $302.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $741.31 Typical High $1,000.00 | Professional | 50 · Both sides | $389.05 | $741.31 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $245.47 Typical High $338.84 | Professional | 51 · Multiple procedures | $128.82 | $245.47 | $338.84 |
Where North Carolina sits
The same service costs 4.2 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· 32nd of 51
$331
WY $912UT $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.