How much rates vary
Facilitymedian $120 · 10th to 90th $78 to $676Professionalmedian $126 · 10th to 90th $95 to $263
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 $102.33 Median $120.23 Typical High $1,288.25 | Facility | None | $102.33 | $120.23 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $194.98 | Professional | None | $102.33 | $120.23 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $177.83 | Professional | None | $93.33 | $162.18 | $177.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $128.82 | Facility | None | $64.57 | $95.50 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $281.84 | Professional | None | $95.50 | $147.91 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $134.90 Typical High $204.17 | Facility | None | $56.23 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $263.03 | Professional | None | $95.50 | $112.20 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $186.21 | Professional | None | $107.15 | $107.15 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $194.98 | Facility | None | $89.13 | $120.23 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $173.78 | Professional | None | $107.15 | $131.83 | $173.78 |
Oscar Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $257.04 | Professional | None | $81.28 | $109.65 | $257.04 |
8 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 $51.29 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $81.28 Typical High $91.20 | Professional | 54 · Surgery only | $75.86 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $75.86 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $70.79 | $75.86 | $85.11 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $41.69 Median $60.26 Typical High $97.72 | Facility | 51 · Multiple procedures | $41.69 | $60.26 | $97.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $66.07 Typical High $95.50 | Professional | 51 · Multiple procedures | $53.70 | $66.07 | $95.50 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska 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· 33rd of 51
$126
AK $437KY $100
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.