How much rates vary
Facilitymedian $2,089 · 10th to 90th $589 to $7,943Professionalmedian $1,000 · 10th to 90th $617 to $1,549
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 $467.74 Median $630.96 Typical High $7,943.28 | Facility | None | $467.74 | $630.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $954.99 | Professional | None | $446.68 | $660.69 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $6,165.95 | Facility | None | $1,445.44 | $1,995.26 | $6,165.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,548.82 | Professional | None | $676.08 | $1,023.29 | $1,548.82 |
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 $588.84 Median $645.65 Typical High $977.24 | Professional | None | $588.84 | $645.65 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $446.68 Median $691.83 Typical High $691.83 | Professional | None | $446.68 | $691.83 | $691.83 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | None | $549.54 | $549.54 | $562.34 |
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 $446.68 Median $575.44 Typical High $933.25 | Professional | None | $446.68 | $575.44 | $933.25 |
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 $234.42 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $54.95 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 59 · Distinct service | $363.08 | $363.08 | $363.08 |
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 $223.87 Median $346.74 Typical High $363.08 | Professional | 51 · Multiple procedures | $223.87 | $346.74 | $363.08 |
Where North Carolina sits
The same service costs 5.9 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 $8,723MT $1,483
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.