How much rates vary
Facilitymedian $251 · 10th to 90th $89 to $1,862Professionalmedian $759 · 10th to 90th $162 to $1,778
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 $141.25 Median $588.84 Typical High $7,413.10 | Facility | None | $141.25 | $588.84 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $588.84 Typical High $891.25 | Professional | None | $141.25 | $588.84 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $204.17 | Professional | None | $112.20 | $186.21 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $218.78 Median $758.58 Typical High $1,949.84 | Professional | None | $218.78 | $758.58 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $2,187.76 | Facility | None | $478.63 | $602.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $467.74 Typical High $1,318.26 | Professional | None | $154.88 | $467.74 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $954.99 | Facility | None | $141.25 | $229.09 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $1,096.48 | Professional | None | $549.54 | $977.24 | $1,096.48 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $147.91 Median $630.96 Typical High $1,380.38 | Professional | None | $147.91 | $630.96 | $1,380.38 |
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 $70.79 Median $100.00 Typical High $309.03 | Professional | 52 · Reduced service | $70.79 | $100.00 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $123.03 | Professional | 53 · Discontinued | $28.18 | $40.74 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $457.09 | Professional | 54 · Surgery only | $107.15 | $151.36 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $91.20 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $61.66 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $61.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $478.63 Typical High $891.25 | Professional | 51 · Multiple procedures | $275.42 | $478.63 | $891.25 |
Where North Carolina sits
The same service costs 17.4 times more in Alabama 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
AL $9,157MT $526
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.