How much rates vary
Facilitymedian $1,413 · 10th to 90th $501 to $3,388Professionalmedian $355 · 10th to 90th $219 to $676
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 $234.42 Median $1,000.00 Typical High $7,943.28 | Facility | None | $234.42 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | None | $234.42 | $234.42 | $316.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,398.83 | Facility | None | $1,174.90 | $1,737.80 | $2,398.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $691.83 | Professional | None | $218.78 | $426.58 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,187.76 | Facility | None | $602.56 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $478.63 | Professional | None | $194.98 | $257.04 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | None | $389.05 | $389.05 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $1,288.25 Typical High $2,691.53 | Facility | None | $234.42 | $1,288.25 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $380.19 | Professional | None | $223.87 | $302.00 | $380.19 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $537.03 | Professional | None | $194.98 | $257.04 | $537.03 |
6 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 $117.49 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $46.77 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $27.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $151.36 Typical High $275.42 | Professional | 51 · Multiple procedures | $112.20 | $151.36 | $275.42 |
Where North Carolina sits
The same service costs 6.2 times more in Colorado 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
CO $4,689MT $752
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.