How much rates vary
Facilitymedian $2,455 · 10th to 90th $759 to $8,318Professionalmedian $724 · 10th to 90th $537 to $1,413
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 $478.63 Median $1,584.89 Typical High $10,964.78 | Facility | None | $478.63 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,288.25 | Professional | None | $478.63 | $478.63 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,862.09 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,412.54 | Professional | None | $588.84 | $851.14 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $5,011.87 | Facility | None | $602.56 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,318.26 | Professional | None | $575.44 | $707.95 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,621.81 Typical High $4,168.69 | Facility | None | $933.25 | $1,621.81 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $812.83 | Professional | None | $489.78 | $660.69 | $812.83 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,288.25 | Professional | None | $478.63 | $691.83 | $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 $234.42 Median $234.42 Typical High $309.03 | Professional | 52 · Reduced service | $234.42 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $512.86 Median $812.83 Typical High $2,137.96 | Facility | 51 · Multiple procedures | $512.86 | $812.83 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $331.13 Typical High $691.83 | Professional | 51 · Multiple procedures | $239.88 | $331.13 | $691.83 |
Where North Carolina sits
The same service costs 5.4 times more in Connecticut 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
CT $7,713MT $1,433
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.