How much rates vary
Facilitymedian $1,514 · 10th to 90th $550 to $4,365Professionalmedian $204 · 10th to 90th $132 to $427
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 $128.82 Median $177.83 Typical High $7,585.78 | Facility | None | $128.82 | $177.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $316.23 | Professional | None | $128.82 | $128.82 | $316.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,137.96 | Facility | None | $1,071.52 | $1,548.82 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $426.58 | Professional | None | $162.18 | $204.17 | $426.58 |
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 $165.96 Median $186.21 Typical High $346.74 | Professional | None | $165.96 | $186.21 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,513.56 | Facility | None | $446.68 | $851.14 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $245.47 | Professional | None | $181.97 | $234.42 | $245.47 |
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 $131.83 Median $204.17 Typical High $331.13 | Professional | None | $131.83 | $204.17 | $331.13 |
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 $64.57 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | 54 · Surgery only | $95.50 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $25.12 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $89.13 | $89.13 | $117.49 |
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 $263.03 Median $467.74 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $263.03 | $467.74 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $354.81 Typical High $436.52 | Professional | 50 · Both sides | $275.42 | $354.81 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $117.49 Typical High $144.54 | Professional | 51 · Multiple procedures | $91.20 | $117.49 | $144.54 |
Where North Carolina sits
The same service costs 11.0 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 $4,556MT $413
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.