How much rates vary
Facilitymedian $1,585 · 10th to 90th $525 to $5,754Professionalmedian $759 · 10th to 90th $229 to $1,514
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 $177.83 Median $602.56 Typical High $8,511.38 | Facility | None | $177.83 | $602.56 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $562.34 Typical High $977.24 | Professional | None | $177.83 | $562.34 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,348.96 | $1,995.26 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $316.23 Median $977.24 Typical High $1,698.24 | Professional | None | $316.23 | $977.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $1,096.48 | Facility | None | $416.87 | $707.95 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $630.96 Typical High $1,230.27 | Professional | None | $229.09 | $630.96 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,659.59 Typical High $3,162.28 | Facility | None | $602.56 | $1,659.59 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,258.93 | Professional | None | $549.54 | $912.01 | $1,258.93 |
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 $199.53 Median $575.44 Typical High $1,348.96 | Professional | None | $199.53 | $575.44 | $1,348.96 |
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 52 · Reduced service Typical Low $89.13 Median $147.91 Typical High $309.03 | Professional | 52 · Reduced service | $89.13 | $147.91 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $58.88 Typical High $123.03 | Professional | 53 · Discontinued | $35.48 | $58.88 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $223.87 Typical High $467.74 | Professional | 54 · Surgery only | $131.83 | $223.87 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $44.67 Typical High $93.33 | Professional | 55 · Aftercare only | $26.30 | $44.67 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $29.51 Typical High $61.66 | Professional | 56 · Pre-op care only | $17.78 | $29.51 | $61.66 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $537.03 Median $831.76 Typical High $2,290.87 | Facility | 51 · Multiple procedures | $537.03 | $831.76 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $630.96 Typical High $851.14 | Professional | 51 · Multiple procedures | $275.42 | $630.96 | $851.14 |
Where North Carolina sits
The same service costs 6.9 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 $7,377MT $1,063
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.