How much rates vary
Facilitymedian $2,138 · 10th to 90th $708 to $5,248Professionalmedian $617 · 10th to 90th $363 to $933
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 $354.81 Median $478.63 Typical High $10,471.29 | Facility | None | $354.81 | $478.63 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $575.44 | Professional | None | $354.81 | $354.81 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | None | $323.59 | $478.63 | $478.63 |
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 $457.09 Median $691.83 Typical High $977.24 | Professional | None | $457.09 | $691.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,388.44 | Facility | None | $794.33 | $2,511.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $954.99 | Professional | None | $416.87 | $501.19 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $2,344.23 | Facility | None | $707.95 | $1,202.26 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $645.65 | Professional | None | $416.87 | $524.81 | $645.65 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $870.96 | Professional | None | $354.81 | $457.09 | $870.96 |
7 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 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $42.66 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,862.09 Typical High $4,786.30 | Facility | 50 · Both sides | $1,096.48 | $1,862.09 | $4,786.30 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $616.60 Typical High $1,584.89 | Facility | 51 · Multiple procedures | $363.08 | $616.60 | $1,584.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $891.25 Typical High $1,548.82 | Professional | 50 · Both sides | $707.95 | $891.25 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $295.12 Typical High $512.86 | Professional | 51 · Multiple procedures | $234.42 | $295.12 | $512.86 |
Where North Carolina sits
The same service costs 6.7 times more in Oklahoma 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
OK $7,024MT $1,050
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.