How much rates vary
Facilitymedian $1,905 · 10th to 90th $603 to $7,413Professionalmedian $977 · 10th to 90th $575 to $1,479
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 $457.09 Median $602.56 Typical High $7,762.47 | Facility | None | $457.09 | $602.56 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | None | $524.81 | $524.81 | $645.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,754.23 | Facility | None | $1,071.52 | $1,698.24 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,479.11 | Professional | None | $660.69 | $977.24 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,912.51 | Facility | None | $602.56 | $5,370.32 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $933.25 | Professional | None | $575.44 | $616.60 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,148.15 Typical High $5,128.61 | Facility | None | $724.44 | $1,148.15 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $660.69 | Professional | None | $426.58 | $660.69 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | None | $524.81 | $524.81 | $537.03 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $891.25 | Professional | None | $436.52 | $549.54 | $891.25 |
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 $223.87 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $53.70 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $346.74 Median $346.74 Typical High $831.76 | Professional | 59 · Distinct service | $346.74 | $346.74 | $831.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $575.44 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $363.08 | $575.44 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $331.13 Typical High $363.08 | Professional | 51 · Multiple procedures | $213.80 | $331.13 | $363.08 |
Where North Carolina sits
The same service costs 6.1 times more in Alaska 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
AK $8,625MT $1,416
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.