How much rates vary
Facilitymedian $1,000 · 10th to 90th $501 to $2,951Professionalmedian $209 · 10th to 90th $112 to $309
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 $104.71 Median $1,148.15 Typical High $7,943.28 | Facility | None | $104.71 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $147.91 | Professional | None | $104.71 | $104.71 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $229.09 | Professional | None | $93.33 | $165.96 | $229.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $630.96 Median $933.25 Typical High $1,258.93 | Facility | None | $630.96 | $933.25 | $1,258.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $309.03 | Professional | None | $131.83 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,288.25 Typical High $2,187.76 | Facility | None | $602.56 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $213.80 | Professional | None | $107.15 | $112.20 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $912.01 Typical High $1,230.27 | Facility | None | $177.83 | $912.01 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | None | $100.00 | $120.23 | $158.49 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | None | $100.00 | $100.00 | $104.71 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $204.17 | Professional | None | $87.10 | $117.49 | $204.17 |
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 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | 54 · Surgery only | $79.43 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $13.18 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $457.09 Typical High $851.14 | Facility | 51 · Multiple procedures | $295.12 | $457.09 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $60.26 Typical High $79.43 | Professional | 51 · Multiple procedures | $50.12 | $60.26 | $79.43 |
Where North Carolina sits
The same service costs 14.5 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 $4,506MT $310
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.