How much rates vary
Facilitymedian $871 · 10th to 90th $479 to $2,818Professionalmedian $550 · 10th to 90th $316 to $813
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 $245.47 Median $1,000.00 Typical High $7,943.28 | Facility | None | $245.47 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | None | $245.47 | $245.47 | $354.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $1,148.15 | Facility | None | $575.44 | $851.14 | $1,148.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $812.83 | Professional | None | $363.08 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,995.26 | Facility | None | $602.56 | $1,071.52 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $776.25 | Professional | None | $269.15 | $389.05 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $1,348.96 | Facility | None | $467.74 | $724.44 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | None | $234.42 | $363.08 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $489.78 | Professional | None | $234.42 | $302.00 | $489.78 |
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 $123.03 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $29.51 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 51 · Multiple procedures | $229.09 | $229.09 | $229.09 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $234.42 Median $363.08 Typical High $676.08 | Facility | 51 · Multiple procedures | $234.42 | $363.08 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $181.97 Typical High $181.97 | Professional | 51 · Multiple procedures | $117.49 | $181.97 | $181.97 |
Where North Carolina sits
The same service costs 5.6 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 $4,320MT $769
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.