How much rates vary
Facilitymedian $724 · 10th to 90th $347 to $1,862Professionalmedian $501 · 10th to 90th $224 to $891
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 $151.36 Median $316.23 Typical High $5,248.07 | Facility | None | $151.36 | $316.23 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $380.19 | Professional | None | $151.36 | $316.23 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $229.09 | Professional | None | $131.83 | $194.98 | $229.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $1,000.00 | Facility | None | $501.19 | $741.31 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $251.19 Median $501.19 Typical High $912.01 | Professional | None | $251.19 | $501.19 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $851.14 Typical High $1,348.96 | Facility | None | $416.87 | $851.14 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $489.78 | Professional | None | $181.97 | $346.74 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | None | $489.78 | $489.78 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $1,023.29 | Facility | None | $302.00 | $489.78 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $446.68 | Professional | None | $295.12 | $426.58 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
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 $154.88 Median $288.40 Typical High $457.09 | Professional | None | $154.88 | $288.40 | $457.09 |
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 Facility Modifier 53 · Discontinued Typical Low $30.20 Median $91.20 Typical High $186.21 | Facility | 53 · Discontinued | $30.20 | $91.20 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $89.13 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $63.10 Typical High $158.49 | Professional | 53 · Discontinued | $30.20 | $63.10 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $114.82 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $22.91 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.14 | $28.84 | $32.36 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $245.47 Typical High $512.86 | Facility | 51 · Multiple procedures | $186.21 | $245.47 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $213.80 Typical High $239.88 | Professional | 51 · Multiple procedures | $147.91 | $213.80 | $239.88 |
Where North Carolina sits
The same service costs 4.7 times more in Connecticut 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
CT $3,190ND $672
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.