How much rates vary
Facilitymedian $158 · 10th to 90th $79 to $2,630Professionalmedian $229 · 10th to 90th $83 to $417
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 $81.28 Median $158.49 Typical High $5,248.07 | Facility | None | $81.28 | $158.49 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $257.04 | Professional | None | $81.28 | $158.49 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $234.42 | Professional | None | $114.82 | $158.49 | $234.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,715.35 Median $5,754.40 Typical High $14,791.08 | Facility | None | $3,715.35 | $5,754.40 | $14,791.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $302.00 Typical High $416.87 | Professional | None | $114.82 | $302.00 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $213.80 Typical High $331.13 | Professional | None | $81.28 | $213.80 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | None | $331.13 | $331.13 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $588.84 | Facility | None | $109.65 | $109.65 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $724.44 | Professional | None | $190.55 | $239.88 | $724.44 |
Oscar Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $2,137.96 | Facility | None | $398.11 | $398.11 | $2,137.96 |
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 $74.13 Median $154.88 Typical High $295.12 | Professional | None | $74.13 | $154.88 | $295.12 |
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 $40.74 Median $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $40.74 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $16.22 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.13 | $13.80 | $15.85 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $234.42 Typical High $331.13 | Professional | 50 · Both sides | $173.78 | $234.42 | $331.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $501.19 Typical High $1,096.48 | Professional | 50 · Both sides | $331.13 | $501.19 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $169.82 Typical High $363.08 | Professional | 51 · Multiple procedures | $109.65 | $169.82 | $363.08 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 8th of 51
$229
AK $417VA $107
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.