How much rates vary
Facilitymedian $955 · 10th to 90th $427 to $3,548Professionalmedian $447 · 10th to 90th $263 to $776
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 $223.87 Median $295.12 Typical High $7,585.78 | Facility | None | $223.87 | $295.12 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $363.08 | Professional | None | $223.87 | $295.12 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | None | $524.81 | $524.81 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $5,370.32 | Facility | None | $1,348.96 | $2,089.30 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $831.76 | Professional | None | $309.03 | $512.86 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,819.70 | Facility | None | $602.56 | $1,096.48 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $512.86 | Professional | None | $251.19 | $323.59 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $794.33 Typical High $1,288.25 | Facility | None | $354.81 | $794.33 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $416.87 | Professional | None | $288.40 | $323.59 | $416.87 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | None | $288.40 | $288.40 | $302.00 |
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 $213.80 Median $288.40 Typical High $478.63 | Professional | None | $213.80 | $288.40 | $478.63 |
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 $109.65 Median $144.54 Typical High $154.88 | Professional | 52 · Reduced service | $109.65 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $57.54 Typical High $61.66 | Professional | 53 · Discontinued | $44.67 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $165.96 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $46.77 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.84 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.39 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $154.88 | $204.17 | $218.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $457.09 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $257.04 | $457.09 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $162.18 Typical High $218.78 | Professional | 51 · Multiple procedures | $144.54 | $162.18 | $218.78 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 12th of 51
$447
AK $933UT $219
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.