How much rates vary
Facilitymedian $1,000 · 10th to 90th $513 to $3,467Professionalmedian $759 · 10th to 90th $513 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 $512.86 Median $851.14 Typical High $7,943.28 | Facility | None | $512.86 | $851.14 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $812.83 | Professional | None | $512.86 | $512.86 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,715.35 | Facility | None | $933.25 | $1,445.44 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,513.56 | Professional | None | $616.60 | $870.96 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,202.26 | Professional | None | $524.81 | $549.54 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,202.26 | Professional | None | $776.25 | $776.25 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $1,479.11 | Facility | None | $524.81 | $794.33 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $851.14 | Professional | None | $512.86 | $630.96 | $851.14 |
Oscar Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $8,511.38 | Facility | None | $3,981.07 | $3,981.07 | $8,511.38 |
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 $436.52 Median $562.34 Typical High $1,288.25 | Professional | None | $436.52 | $562.34 | $1,288.25 |
8 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 $257.04 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $416.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $398.11 Typical High $724.44 | Facility | 51 · Multiple procedures | $257.04 | $398.11 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $323.59 Typical High $630.96 | Professional | 51 · Multiple procedures | $257.04 | $323.59 | $630.96 |
Where North Carolina sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $5,106MD $1,261
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.