How much rates vary
Facilitymedian $468 · 10th to 90th $209 to $5,248Professionalmedian $257 · 10th to 90th $141 to $501
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 $141.25 Median $229.09 Typical High $7,585.78 | Facility | None | $141.25 | $229.09 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $371.54 | Professional | None | $141.25 | $229.09 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $223.87 | Professional | None | $123.03 | $123.03 | $223.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $588.84 | Facility | None | $147.91 | $229.09 | $588.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $575.44 | Professional | None | $147.91 | $263.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $616.60 | Facility | None | $204.17 | $323.59 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $398.11 | Professional | None | $120.23 | $199.53 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $446.68 | Facility | None | $181.97 | $281.84 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $501.19 | Professional | None | $165.96 | $288.40 | $501.19 |
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 $141.25 Median $204.17 Typical High $363.08 | Professional | None | $141.25 | $204.17 | $363.08 |
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 $70.79 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $70.79 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $28.18 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $20.89 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $158.49 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $269.15 Median $416.87 Typical High $660.69 | Facility | 50 · Both sides | $269.15 | $416.87 | $660.69 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $89.13 Median $141.25 Typical High $223.87 | Facility | 51 · Multiple procedures | $89.13 | $141.25 | $223.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $549.54 Typical High $758.58 | Professional | 50 · Both sides | $245.47 | $549.54 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $186.21 Typical High $251.19 | Professional | 51 · Multiple procedures | $83.18 | $186.21 | $251.19 |
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· 20th of 51
$263
WY $692UT $166
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.