How much rates vary
Facilitymedian $155 · 10th to 90th $78 to $1,096Professionalmedian $240 · 10th to 90th $93 to $513
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 $75.86 Median $239.88 Typical High $5,248.07 | Facility | None | $75.86 | $239.88 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $323.59 | Professional | None | $75.86 | $186.21 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $288.40 | Professional | None | $123.03 | $123.03 | $288.40 |
BCBS North Carolina Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $234.42 | Facility | None | $58.88 | $91.20 | $234.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $575.44 | Professional | None | $123.03 | $245.47 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $1,318.26 | Facility | None | $87.10 | $141.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $446.68 | Professional | None | $95.50 | $186.21 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $309.03 Typical High $501.19 | Facility | None | $77.62 | $309.03 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $389.05 | Professional | None | $229.09 | $263.03 | $389.05 |
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 $79.43 Median $186.21 Typical High $416.87 | Professional | None | $79.43 | $186.21 | $416.87 |
9 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 $38.02 Median $72.44 Typical High $120.23 | Professional | 52 · Reduced service | $38.02 | $72.44 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $28.84 Typical High $48.98 | Professional | 53 · Discontinued | $15.14 | $28.84 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $107.15 Typical High $181.97 | Professional | 54 · Surgery only | $56.23 | $107.15 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $21.38 Typical High $36.31 | Professional | 55 · Aftercare only | $11.48 | $21.38 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $14.45 Typical High $23.99 | Professional | 56 · Pre-op care only | $7.59 | $14.45 | $23.99 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $114.82 Median $562.34 Typical High $758.58 | Facility | 50 · Both sides | $114.82 | $562.34 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $38.90 Median $186.21 Typical High $251.19 | Facility | 51 · Multiple procedures | $38.90 | $186.21 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $398.11 Typical High $933.25 | Professional | 50 · Both sides | $346.74 | $398.11 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $131.83 Typical High $316.23 | Professional | 51 · Multiple procedures | $114.82 | $131.83 | $316.23 |
Where North Carolina sits
The same service costs 9.4 times more in New York 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
NY $2,695MD $285
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.