How much rates vary
Facilitymedian $1,047 · 10th to 90th $479 to $3,311Professionalmedian $603 · 10th to 90th $282 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 $194.98 Median $933.25 Typical High $7,943.28 | Facility | None | $194.98 | $933.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $467.74 | Professional | None | $194.98 | $194.98 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $2,754.23 | Facility | None | $691.83 | $1,071.52 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $316.23 Median $602.56 Typical High $891.25 | Professional | None | $316.23 | $602.56 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $1,819.70 | Facility | None | $602.56 | $1,479.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $616.60 | Professional | None | $275.42 | $288.40 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | None | $426.58 | $426.58 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,258.93 | Facility | None | $446.68 | $660.69 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $371.54 | Professional | None | $186.21 | $323.59 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | None | $316.23 | $316.23 | $331.13 |
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 $194.98 Median $281.84 Typical High $501.19 | Professional | None | $194.98 | $281.84 | $501.19 |
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 $97.72 Median $97.72 Typical High $123.03 | Professional | 52 · Reduced service | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $38.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $24.55 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $331.13 Typical High $851.14 | Facility | 51 · Multiple procedures | $263.03 | $331.13 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $93.33 Median $162.18 Typical High $229.09 | Professional | 51 · Multiple procedures | $93.33 | $162.18 | $229.09 |
Where North Carolina sits
The same service costs 6.8 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 $4,179MT $618
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.