How much rates vary
Facilitymedian $1,514 · 10th to 90th $513 to $5,129Professionalmedian $302 · 10th to 90th $174 to $676
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 $173.78 Median $323.59 Typical High $7,585.78 | Facility | None | $173.78 | $323.59 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $524.81 | Professional | None | $173.78 | $323.59 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $4,265.80 | Facility | None | $1,071.52 | $1,659.59 | $4,265.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $794.33 | Professional | None | $181.97 | $316.23 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,137.96 | Facility | None | $602.56 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $512.86 | Professional | None | $147.91 | $281.84 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $851.14 Typical High $1,513.56 | Facility | None | $323.59 | $851.14 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $489.78 | Professional | None | $263.03 | $380.19 | $489.78 |
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 $173.78 Median $275.42 Typical High $489.78 | Professional | None | $173.78 | $275.42 | $489.78 |
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 $87.10 Median $138.04 Typical High $162.18 | Professional | 52 · Reduced service | $87.10 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $34.67 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $131.83 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $26.30 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.38 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $123.03 | $190.55 | $229.09 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,412.54 Typical High $3,235.94 | Facility | 50 · Both sides | $776.25 | $1,412.54 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $467.74 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $257.04 | $467.74 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $707.95 Typical High $741.31 | Professional | 50 · Both sides | $389.05 | $707.95 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $239.88 Typical High $245.47 | Professional | 51 · Multiple procedures | $131.83 | $239.88 | $245.47 |
Where North Carolina sits
The same service costs 6.3 times more in Colorado than in Montana. 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
CO $4,654MT $736
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.