How much rates vary
Facilitymedian $110 · 10th to 90th $58 to $724Professionalmedian $155 · 10th to 90th $66 to $269
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 $57.54 Median $109.65 Typical High $223.87 | Facility | None | $57.54 | $109.65 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $181.97 | Professional | None | $57.54 | $109.65 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $181.97 | Professional | None | $61.66 | $87.10 | $181.97 |
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 $107.15 Median $190.55 Typical High $323.59 | Professional | None | $107.15 | $190.55 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $199.53 | Professional | None | $83.18 | $141.25 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | None | $177.83 | $177.83 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $489.78 | Facility | None | $52.48 | $69.18 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $190.55 | Professional | None | $107.15 | $169.82 | $190.55 |
Oscar Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $54.95 Median $107.15 Typical High $204.17 | Professional | None | $54.95 | $107.15 | $204.17 |
7 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 $28.84 Median $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $28.84 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $19.05 Typical High $21.88 | Professional | 53 · Discontinued | $11.48 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $72.44 Typical High $83.18 | Professional | 54 · Surgery only | $43.65 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $8.71 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.75 | $9.55 | $10.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $26.30 Median $34.67 Typical High $34.67 | Facility | 51 · Multiple procedures | $26.30 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $95.50 Typical High $100.00 | Professional | 51 · Multiple procedures | $53.70 | $95.50 | $100.00 |
Where North Carolina sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.