How much rates vary
Facilitymedian $363 · 10th to 90th $191 to $2,239Professionalmedian $324 · 10th to 90th $162 to $562
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 $125.89 Median $223.87 Typical High $7,413.10 | Facility | None | $125.89 | $223.87 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $269.15 | Professional | None | $125.89 | $218.78 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $302.00 | Facility | None | $151.36 | $229.09 | $302.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $588.84 | Professional | None | $186.21 | $323.59 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $588.84 | Facility | None | $199.53 | $316.23 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $363.08 | Professional | None | $141.25 | $199.53 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $549.54 | Professional | None | $275.42 | $275.42 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $724.44 | Facility | None | $181.97 | $316.23 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $269.15 | Professional | None | $190.55 | $218.78 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | None | $190.55 | $190.55 | $204.17 |
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 $123.03 Median $190.55 Typical High $316.23 | Professional | None | $123.03 | $190.55 | $316.23 |
8 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 $63.10 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $63.10 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $25.12 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $95.50 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.59 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $144.54 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $89.13 | $144.54 | $162.18 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $114.82 Median $213.80 Typical High $363.08 | Facility | 51 · Multiple procedures | $114.82 | $213.80 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $107.15 Typical High $144.54 | Professional | 51 · Multiple procedures | $95.50 | $107.15 | $144.54 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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.
North Carolina· 7th of 51
$324
AK $525DC $158
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.