How much rates vary
Facilitymedian $2,188 · 10th to 90th $851 to $6,026Professionalmedian $1,000 · 10th to 90th $794 to $2,570
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 $1,023.29 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,023.29 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,023.29 | $1,621.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,445.44 | $2,137.96 | $2,951.21 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $3,162.28 | Professional | None | $776.25 | $933.25 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,344.23 Typical High $3,467.37 | Facility | None | $645.65 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,949.84 | Professional | None | $794.33 | $954.99 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $3,162.28 | Facility | None | $602.56 | $1,174.90 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,047.13 | $1,174.90 |
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 $831.76 Median $1,000.00 Typical High $1,995.26 | Professional | None | $831.76 | $1,000.00 | $1,995.26 |
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 $512.86 Median $512.86 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $912.01 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,737.80 Typical High $5,248.07 | Facility | 50 · Both sides | $891.25 | $1,737.80 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $588.84 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $295.12 | $588.84 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,548.82 Typical High $1,862.09 | Professional | 50 · Both sides | $1,479.11 | $1,548.82 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $524.81 Typical High $616.60 | Professional | 51 · Multiple procedures | $489.78 | $524.81 | $616.60 |
Where North Carolina sits
The same service costs 7.2 times more in Alaska 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· 42nd of 51
$1,023
AK $4,266UT $589
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.