How much rates vary
Facilitymedian $1,047 · 10th to 90th $339 to $3,548Professionalmedian $380 · 10th to 90th $224 to $708
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 $218.78 Median $338.84 Typical High $7,585.78 | Facility | None | $218.78 | $338.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $537.03 | Professional | None | $218.78 | $338.84 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $269.15 Median $371.54 Typical High $1,148.15 | Facility | None | $269.15 | $371.54 | $1,148.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $707.95 | Professional | None | $234.42 | $426.58 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $2,691.53 | Facility | None | $524.81 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $691.83 | Professional | None | $275.42 | $371.54 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $380.19 Typical High $1,548.82 | Facility | None | $239.88 | $380.19 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | None | $323.59 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $602.56 | Professional | None | $208.93 | $309.03 | $602.56 |
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 $109.65 Median $138.04 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $33.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $120.23 Median $186.21 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $120.23 | $186.21 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $194.98 Typical High $263.03 | Professional | 51 · Multiple procedures | $162.18 | $194.98 | $263.03 |
Where North Carolina sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.