How much rates vary
Facilitymedian $72 · 10th to 90th $45 to $741Professionalmedian $102 · 10th to 90th $55 to $162
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 $44.67 Median $63.10 Typical High $1,288.25 | Facility | None | $44.67 | $63.10 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $104.71 | Professional | None | $44.67 | $63.10 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $107.15 | Professional | None | $46.77 | $63.10 | $107.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $37.15 Median $54.95 Typical High $74.13 | Facility | None | $37.15 | $54.95 | $74.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $177.83 | Professional | None | $69.18 | $109.65 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $72.44 Typical High $524.81 | Facility | None | $45.71 | $72.44 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $138.04 | Professional | None | $54.95 | $79.43 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | None | $114.82 | $114.82 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $91.20 | Facility | None | $43.65 | $56.23 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $117.49 | Professional | None | $60.26 | $87.10 | $117.49 |
Oscar Health Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $1,778.28 | Facility | None | $43.65 | $43.65 | $1,778.28 |
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 $42.66 Median $63.10 Typical High $128.82 | Professional | None | $42.66 | $63.10 | $128.82 |
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 $21.88 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $21.88 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $8.91 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $44.67 Typical High $47.86 | Professional | 54 · Surgery only | $33.11 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.12 Typical High $9.55 | Professional | 55 · Aftercare only | $6.61 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.47 | $6.03 | $6.31 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $125.89 Typical High $162.18 | Professional | 50 · Both sides | $77.62 | $125.89 | $162.18 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $48.98 Median $85.11 Typical High $114.82 | Facility | 50 · Both sides | $48.98 | $85.11 | $114.82 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $16.22 Median $28.18 Typical High $38.90 | Facility | 51 · Multiple procedures | $16.22 | $28.18 | $38.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $138.04 Typical High $239.88 | Professional | 50 · Both sides | $91.20 | $138.04 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $46.77 Typical High $79.43 | Professional | 51 · Multiple procedures | $30.20 | $46.77 | $79.43 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 7th of 51
$102
AK $224FL $53.70
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.