How much rates vary
Facilitymedian $1,318 · 10th to 90th $347 to $3,890Professionalmedian $263 · 10th to 90th $138 to $525
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 $120.23 Median $208.93 Typical High $7,413.10 | Facility | None | $120.23 | $208.93 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $245.47 | Professional | None | $120.23 | $204.17 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $537.03 | Professional | None | $169.82 | $281.84 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $2,951.21 | Facility | None | $457.09 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $331.13 | Professional | None | $128.82 | $213.80 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $512.86 | Professional | None | $295.12 | $295.12 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $549.54 Typical High $1,949.84 | Facility | None | $223.87 | $549.54 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | None | $204.17 | $239.88 | $239.88 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | None | $169.82 | $169.82 | $181.97 |
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 $112.20 Median $177.83 Typical High $295.12 | Professional | None | $112.20 | $177.83 | $295.12 |
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 $58.88 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $58.88 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $23.99 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $89.13 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.02 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $83.18 | $131.83 | $147.91 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $354.81 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $186.21 | $354.81 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $120.23 Typical High $151.36 | Professional | 51 · Multiple procedures | $102.33 | $120.23 | $151.36 |
Where North Carolina sits
The same service costs 9.8 times more in Colorado than in North Dakota. 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
CO $4,589ND $469
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.