How much rates vary
Facilitymedian $1,000 · 10th to 90th $389 to $2,692Professionalmedian $295 · 10th to 90th $155 to $794
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 $389.05 Typical High $7,413.10 | Facility | None | $125.89 | $389.05 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $354.81 Typical High $426.58 | Professional | None | $125.89 | $354.81 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,348.96 | Facility | None | $676.08 | $1,000.00 | $1,348.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $812.83 | Professional | None | $173.78 | $323.59 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,778.28 | Facility | None | $457.09 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $616.60 | Professional | None | $154.88 | $169.82 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $933.25 | Professional | None | $229.09 | $229.09 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $1,258.93 | Facility | None | $302.00 | $575.44 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $416.87 | Professional | None | $181.97 | $204.17 | $416.87 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | None | $177.83 | $177.83 | $186.21 |
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 $125.89 Median $173.78 Typical High $489.78 | Professional | None | $125.89 | $173.78 | $489.78 |
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 $63.10 Median $134.90 Typical High $190.55 | Professional | 52 · Reduced service | $63.10 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $53.70 Typical High $77.62 | Professional | 53 · Discontinued | $25.12 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $204.17 Typical High $288.40 | Professional | 54 · Surgery only | $95.50 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $40.74 Typical High $57.54 | Professional | 55 · Aftercare only | $19.05 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $26.92 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.59 | $26.92 | $38.90 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $281.84 Typical High $851.14 | Facility | 51 · Multiple procedures | $186.21 | $281.84 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $100.00 Typical High $208.93 | Professional | 51 · Multiple procedures | $91.20 | $100.00 | $208.93 |
Where North Carolina sits
The same service costs 5.7 times more in Colorado 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
CO $4,090MT $722
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.