How much rates vary
Facilitymedian $15,488 · 10th to 90th $871 to $31,623Professionalmedian $5,888 · 10th to 90th $631 to $16,218
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 $501.19 Median $5,248.07 Typical High $10,964.78 | Facility | None | $501.19 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $4,897.79 Typical High $7,413.10 | Professional | None | $501.19 | $4,897.79 | $7,413.10 |
BCBS North Carolina Setting Facility Modifier None Typical Low $9,332.54 Median $15,488.17 Typical High $23,988.33 | Facility | None | $9,332.54 | $15,488.17 | $23,988.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $5,888.44 Typical High $17,782.79 | Professional | None | $870.96 | $5,888.44 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $18,197.01 Typical High $29,512.09 | Facility | None | $602.56 | $18,197.01 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,698.24 Typical High $12,022.64 | Professional | None | $616.60 | $1,698.24 | $12,022.64 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $14,791.08 Typical High $26,302.68 | Facility | None | $602.56 | $14,791.08 | $26,302.68 |
Medcost Setting Professional Modifier None Typical Low $5,011.87 Median $8,912.51 Typical High $10,232.93 | Professional | None | $5,011.87 | $8,912.51 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $18,620.87 Typical High $45,708.82 | Facility | None | $2,238.72 | $18,620.87 | $45,708.82 |
United Setting Professional Modifier None Typical Low $549.54 Median $3,890.45 Typical High $12,589.25 | Professional | None | $549.54 | $3,890.45 | $12,589.25 |
6 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 $251.19 Median $407.38 Typical High $2,754.23 | Professional | 52 · Reduced service | $251.19 | $407.38 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $162.18 Typical High $1,096.48 | Professional | 53 · Discontinued | $100.00 | $162.18 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $602.56 Typical High $4,168.69 | Professional | 54 · Surgery only | $371.54 | $602.56 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $120.23 Typical High $831.76 | Professional | 55 · Aftercare only | $74.13 | $120.23 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $81.28 Typical High $549.54 | Professional | 56 · Pre-op care only | $50.12 | $81.28 | $549.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,511.89 Median $4,466.84 Typical High $8,317.64 | Professional | 51 · Multiple procedures | $2,511.89 | $4,466.84 | $8,317.64 |
Where North Carolina sits
The same service costs 6.1 times more in Alaska than in Vermont. 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
AK $33,081VT $5,424
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.