How much rates vary
Facilitymedian $372 · 10th to 90th $123 to $2,951Professionalmedian $251 · 10th to 90th $126 to $389
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 $107.15 Median $144.54 Typical High $7,413.10 | Facility | None | $107.15 | $144.54 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $177.83 | Professional | None | $107.15 | $144.54 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $269.15 | Professional | None | $144.54 | $144.54 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $97.72 Median $154.88 Typical High $389.05 | Facility | None | $97.72 | $154.88 | $389.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $416.87 | Professional | None | $147.91 | $251.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $524.81 | Facility | None | $117.49 | $186.21 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $257.04 | Professional | None | $117.49 | $151.36 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $346.74 | Professional | None | $213.80 | $213.80 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $177.83 Typical High $263.03 | Facility | None | $114.82 | $177.83 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $186.21 | Professional | None | $138.04 | $177.83 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | None | $151.36 | $151.36 | $162.18 |
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 $104.71 Median $141.25 Typical High $234.42 | Professional | None | $104.71 | $141.25 | $234.42 |
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 $53.70 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $79.43 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $15.85 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $97.72 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $74.13 | $97.72 | $104.71 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $61.66 Median $89.13 Typical High $131.83 | Facility | 51 · Multiple procedures | $61.66 | $89.13 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $89.13 Typical High $109.65 | Professional | 51 · Multiple procedures | $69.18 | $89.13 | $109.65 |
Where North Carolina sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$251
AK $437NJ $110
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.