How much rates vary
Facilitymedian $9,120 · 10th to 90th $676 to $23,442Professionalmedian $5,495 · 10th to 90th $562 to $10,471
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 $416.87 Median $4,073.80 Typical High $7,943.28 | Facility | None | $416.87 | $4,073.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $4,073.80 Typical High $6,309.57 | Professional | None | $416.87 | $4,073.80 | $6,309.57 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $7,585.78 | Professional | None | $562.34 | $616.60 | $7,585.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $12,022.64 Median $16,218.10 Typical High $51,286.14 | Facility | None | $12,022.64 | $16,218.10 | $51,286.14 |
BCBS North Carolina Setting Professional Modifier None Typical Low $741.31 Median $5,754.40 Typical High $11,220.18 | Professional | None | $741.31 | $5,754.40 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $9,772.37 Typical High $16,218.10 | Facility | None | $602.56 | $9,772.37 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,513.56 Typical High $9,549.93 | Professional | None | $562.34 | $1,513.56 | $9,549.93 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $6,918.31 Typical High $10,964.78 | Facility | None | $676.08 | $6,918.31 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $5,248.07 Median $6,025.60 Typical High $7,762.47 | Professional | None | $5,248.07 | $6,025.60 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $478.63 Median $3,019.95 Typical High $10,000.00 | Professional | None | $478.63 | $3,019.95 | $10,000.00 |
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 $208.93 Median $363.08 Typical High $2,344.23 | Professional | 52 · Reduced service | $208.93 | $363.08 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $144.54 Typical High $954.99 | Professional | 53 · Discontinued | $83.18 | $144.54 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $537.03 Typical High $3,548.13 | Professional | 54 · Surgery only | $316.23 | $537.03 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $109.65 Typical High $707.95 | Professional | 55 · Aftercare only | $63.10 | $109.65 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $72.44 Typical High $467.74 | Professional | 56 · Pre-op care only | $41.69 | $72.44 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,019.95 Median $3,019.95 Typical High $6,606.93 | Professional | 51 · Multiple procedures | $3,019.95 | $3,019.95 | $6,606.93 |
Where North Carolina sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.