How much rates vary
Facilitymedian $1,514 · 10th to 90th $631 to $5,248Professionalmedian $741 · 10th to 90th $562 to $1,905
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 $630.96 Median $758.58 Typical High $7,943.28 | Facility | None | $630.96 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,202.26 | Professional | None | $630.96 | $758.58 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $4,265.80 | Facility | None | $1,071.52 | $1,698.24 | $4,265.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $2,041.74 | Professional | None | $602.56 | $724.44 | $2,041.74 |
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 $512.86 Median $616.60 Typical High $1,380.38 | Professional | None | $512.86 | $616.60 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $912.01 Typical High $2,137.96 | Facility | None | $588.84 | $912.01 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,047.13 | Professional | None | $741.31 | $912.01 | $1,047.13 |
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 $588.84 Median $741.31 Typical High $1,445.44 | Professional | None | $588.84 | $741.31 | $1,445.44 |
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 $316.23 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $125.89 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $602.56 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,445.44 Typical High $3,235.94 | Facility | 50 · Both sides | $891.25 | $1,445.44 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,348.96 Typical High $1,584.89 | Professional | 50 · Both sides | $1,096.48 | $1,348.96 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $457.09 Typical High $524.81 | Professional | 51 · Multiple procedures | $363.08 | $457.09 | $524.81 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in West Virginia. 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.
Physician feeFacility fee
AK $6,098WV $1,627
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.