How much rates vary
Facilitymedian $871 · 10th to 90th $407 to $2,455Professionalmedian $501 · 10th to 90th $229 to $646
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 $165.96 Median $870.96 Typical High $7,943.28 | Facility | None | $165.96 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | None | $165.96 | $165.96 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,174.90 | Facility | None | $588.84 | $870.96 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $660.69 | Professional | None | $257.04 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,412.54 | Facility | None | $457.09 | $1,071.52 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $389.05 | Professional | None | $239.88 | $257.04 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $933.25 | Facility | None | $371.54 | $489.78 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $316.23 | Professional | None | $158.49 | $288.40 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | None | $269.15 | $269.15 | $281.84 |
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 $165.96 Median $229.09 Typical High $346.74 | Professional | None | $165.96 | $229.09 | $346.74 |
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 $83.18 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $33.11 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $19.95 |
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 $79.43 Median $144.54 Typical High $199.53 | Professional | 51 · Multiple procedures | $79.43 | $144.54 | $199.53 |
Where North Carolina sits
The same service costs 7.7 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 $4,047MT $526
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.