How much rates vary
Facilitymedian $2,089 · 10th to 90th $490 to $5,248Professionalmedian $288 · 10th to 90th $186 to $562
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 $173.78 Median $239.88 Typical High $7,943.28 | Facility | None | $173.78 | $239.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $331.13 | Professional | None | $173.78 | $173.78 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,398.83 | $3,235.94 |
BCBS North Carolina Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $575.44 | Professional | None | $186.21 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,388.44 | Facility | None | $645.65 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $478.63 | Professional | None | $223.87 | $257.04 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $3,162.28 | Facility | None | $446.68 | $977.24 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $389.05 | Professional | None | $208.93 | $281.84 | $389.05 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,905.46 Typical High $8,709.64 | Facility | None | $851.14 | $1,905.46 | $8,709.64 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $457.09 | Professional | None | $177.83 | $251.19 | $457.09 |
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 $87.10 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $21.38 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,862.09 Typical High $4,786.30 | Facility | 50 · Both sides | $891.25 | $1,862.09 | $4,786.30 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $616.60 Typical High $1,584.89 | Facility | 51 · Multiple procedures | $295.12 | $616.60 | $1,584.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $457.09 Typical High $758.58 | Professional | 50 · Both sides | $354.81 | $457.09 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $151.36 Typical High $257.04 | Professional | 51 · Multiple procedures | $117.49 | $151.36 | $257.04 |
Where North Carolina sits
The same service costs 11.3 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 $6,151MT $545
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.