How much rates vary
Facilitymedian $468 · 10th to 90th $263 to $4,571Professionalmedian $363 · 10th to 90th $229 to $794
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 $229.09 Median $363.08 Typical High $7,585.78 | Facility | None | $229.09 | $363.08 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $446.68 | Professional | None | $229.09 | $354.81 | $446.68 |
BCBS North Carolina Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $416.87 | Facility | None | $208.93 | $316.23 | $416.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $891.25 | Professional | None | $234.42 | $398.11 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $954.99 | Facility | None | $288.40 | $457.09 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $602.56 | Professional | None | $199.53 | $316.23 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $630.96 | Facility | None | $257.04 | $407.38 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $741.31 | Professional | None | $288.40 | $467.74 | $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 $229.09 Median $338.84 Typical High $575.44 | Professional | None | $229.09 | $338.84 | $575.44 |
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 $114.82 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $114.82 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $32.36 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $251.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $389.05 Median $602.56 Typical High $933.25 | Facility | 50 · Both sides | $389.05 | $602.56 | $933.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $128.82 Median $204.17 Typical High $316.23 | Facility | 51 · Multiple procedures | $128.82 | $204.17 | $316.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $812.83 Typical High $1,122.02 | Professional | 50 · Both sides | $436.52 | $812.83 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $269.15 Typical High $371.54 | Professional | 51 · Multiple procedures | $147.91 | $269.15 | $371.54 |
Where North Carolina sits
The same service costs 3.9 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· 37th of 51
$363
WY $1,096UT $282
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.