How much rates vary
Facilitymedian $1,660 · 10th to 90th $550 to $5,248Professionalmedian $851 · 10th to 90th $417 to $1,445
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 $338.84 Median $457.09 Typical High $7,943.28 | Facility | None | $338.84 | $457.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $741.31 | Professional | None | $338.84 | $338.84 | $741.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $5,011.87 | Facility | None | $1,258.93 | $1,995.26 | $5,011.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,513.56 | Professional | None | $575.44 | $851.14 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $2,454.71 | Facility | None | $645.65 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,071.52 | Professional | None | $489.78 | $691.83 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | None | $794.33 | $1,000.00 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $1,778.28 | Facility | None | $575.44 | $1,023.29 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $707.95 Typical High $794.33 | Professional | None | $407.38 | $707.95 | $794.33 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $954.99 | Professional | None | $295.12 | $549.54 | $954.99 |
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 $169.82 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $39.81 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $512.86 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $295.12 | $512.86 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $389.05 Typical High $478.63 | Professional | 51 · Multiple procedures | $218.78 | $389.05 | $478.63 |
Where North Carolina sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.