How much rates vary
Facilitymedian $234 · 10th to 90th $83 to $1,862Professionalmedian $151 · 10th to 90th $68 to $275
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 $51.29 Median $95.50 Typical High $5,495.41 | Facility | None | $51.29 | $95.50 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $125.89 | Professional | None | $51.29 | $95.50 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $181.97 | Professional | None | $45.71 | $75.86 | $181.97 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $316.23 | Facility | None | $79.43 | $123.03 | $316.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $288.40 | Professional | None | $85.11 | $151.36 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $524.81 | Facility | None | $79.43 | $123.03 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $165.96 | Professional | None | $64.57 | $107.15 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $239.88 | Professional | None | $144.54 | $144.54 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $134.90 Typical High $199.53 | Facility | None | $91.20 | $134.90 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $154.88 | Professional | None | $91.20 | $131.83 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $147.91 | Professional | None | $53.70 | $89.13 | $147.91 |
7 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 $25.70 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $25.70 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $10.23 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $67.61 Typical High $75.86 | Professional | 54 · Surgery only | $38.90 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $7.76 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.13 | $8.91 | $10.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $45.71 Median $70.79 Typical High $100.00 | Facility | 51 · Multiple procedures | $45.71 | $70.79 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $66.07 Typical High $77.62 | Professional | 51 · Multiple procedures | $45.71 | $66.07 | $77.62 |
Where North Carolina sits
The same service costs 13.8 times more in Connecticut 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
CT $2,817MT $205
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.