How much rates vary
Facilitymedian $2,344 · 10th to 90th $741 to $6,918Professionalmedian $776 · 10th to 90th $513 to $1,549
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 $616.60 Median $1,288.25 Typical High $10,471.29 | Facility | None | $616.60 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $891.25 | Professional | None | $616.60 | $616.60 | $891.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $6,456.54 | Facility | None | $1,288.25 | $1,995.26 | $6,456.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $489.78 Median $1,096.48 Typical High $2,041.74 | Professional | None | $489.78 | $1,096.48 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,467.37 | Facility | None | $794.33 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,230.27 | Professional | None | $512.86 | $602.56 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,398.83 | Facility | None | $724.44 | $1,174.90 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,047.13 | Professional | None | $602.56 | $602.56 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,348.96 | Professional | None | $549.54 | $645.65 | $1,348.96 |
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 $309.03 Median $309.03 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $562.34 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $5,248.07 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $912.01 Typical High $1,584.89 | Professional | 50 · Both sides | $891.25 | $912.01 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $302.00 Typical High $524.81 | Professional | 51 · Multiple procedures | $302.00 | $302.00 | $524.81 |
Where North Carolina sits
The same service costs 8.5 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
$1,000
WY $3,020UT $355
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.