How much rates vary
Facilitymedian $324 · 10th to 90th $191 to $2,455Professionalmedian $251 · 10th to 90th $141 to $501
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 $125.89 Median $208.93 Typical High $7,585.78 | Facility | None | $125.89 | $208.93 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $229.09 | Professional | None | $125.89 | $199.53 | $229.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $165.96 Median $239.88 Typical High $323.59 | Facility | None | $165.96 | $239.88 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $512.86 | Professional | None | $199.53 | $288.40 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $302.00 Typical High $645.65 | Facility | None | $194.98 | $302.00 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $416.87 | Professional | None | $141.25 | $213.80 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $426.58 | Facility | None | $190.55 | $295.12 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $338.84 | Professional | None | $194.98 | $251.19 | $338.84 |
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 $123.03 Median $208.93 Typical High $416.87 | Professional | None | $123.03 | $208.93 | $416.87 |
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 $63.10 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $63.10 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $25.12 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $95.50 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.59 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $128.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $89.13 | $128.82 | $144.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $288.40 Median $446.68 Typical High $645.65 | Facility | 50 · Both sides | $288.40 | $446.68 | $645.65 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $95.50 Median $147.91 Typical High $213.80 | Facility | 51 · Multiple procedures | $95.50 | $147.91 | $213.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $371.54 Typical High $851.14 | Professional | 50 · Both sides | $295.12 | $371.54 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $125.89 Typical High $281.84 | Professional | 51 · Multiple procedures | $97.72 | $125.89 | $281.84 |
Where North Carolina sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 18th of 51
$257
OK $646KY $166
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.