How much rates vary
Facilitymedian $1,288 · 10th to 90th $398 to $3,715Professionalmedian $589 · 10th to 90th $347 to $1,148
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 $323.59 Median $457.09 Typical High $7,413.10 | Facility | None | $323.59 | $457.09 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $602.56 | Professional | None | $323.59 | $457.09 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $776.25 | Professional | None | $562.34 | $562.34 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,412.54 Typical High $3,715.35 | Facility | None | $933.25 | $1,412.54 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,258.93 | Professional | None | $457.09 | $707.95 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,659.59 Typical High $2,454.71 | Facility | None | $457.09 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $1,000.00 | Professional | None | $354.81 | $467.74 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $1,778.28 | Facility | None | $371.54 | $602.56 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $758.58 | Professional | None | $338.84 | $549.54 | $758.58 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $1,023.29 | Professional | None | $316.23 | $478.63 | $1,023.29 |
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 $162.18 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $64.57 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $239.88 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $323.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,023.29 Typical High $4,365.16 | Facility | 50 · Both sides | $562.34 | $1,023.29 | $4,365.16 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $346.74 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $186.21 | $346.74 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $831.76 Typical High $1,905.46 | Professional | 50 · Both sides | $501.19 | $831.76 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $275.42 Typical High $645.65 | Professional | 51 · Multiple procedures | $169.82 | $275.42 | $645.65 |
Where North Carolina sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.