How much rates vary
Facilitymedian $776 · 10th to 90th $331 to $2,512Professionalmedian $427 · 10th to 90th $166 to $832
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 $117.49 Median $302.00 Typical High $5,248.07 | Facility | None | $117.49 | $302.00 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $302.00 Typical High $371.54 | Professional | None | $117.49 | $302.00 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
BCBS North Carolina Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $1,348.96 | Facility | None | $338.84 | $524.81 | $1,348.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $467.74 Typical High $831.76 | Professional | None | $204.17 | $467.74 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,348.96 | Facility | None | $457.09 | $1,071.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $446.68 | Professional | None | $151.36 | $316.23 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $478.63 Typical High $933.25 | Facility | None | $239.88 | $478.63 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $398.11 | Professional | None | $281.84 | $371.54 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | None | $263.03 | $263.03 | $275.42 |
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 $120.23 Median $257.04 Typical High $416.87 | Professional | None | $120.23 | $257.04 | $416.87 |
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 $58.88 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $58.88 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $23.44 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $87.10 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $17.38 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.75 | $26.92 | $30.90 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $251.19 Typical High $676.08 | Facility | 51 · Multiple procedures | $186.21 | $251.19 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $186.21 Typical High $213.80 | Professional | 51 · Multiple procedures | $141.25 | $186.21 | $213.80 |
Where North Carolina sits
The same service costs 6.9 times more in Colorado 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
CO $4,090ND $590
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.