How much rates vary
Facilitymedian $1,318 · 10th to 90th $282 to $3,890Professionalmedian $331 · 10th to 90th $191 to $631
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 $154.88 Median $281.84 Typical High $5,248.07 | Facility | None | $154.88 | $281.84 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $338.84 | Professional | None | $154.88 | $269.15 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | None | $234.42 | $234.42 | $263.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $5,248.07 | Facility | None | $1,318.26 | $2,089.30 | $5,248.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $691.83 | Professional | None | $218.78 | $380.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,818.38 | Facility | None | $645.65 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $446.68 | Professional | None | $169.82 | $218.78 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $676.08 | Professional | None | $323.59 | $323.59 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $794.33 Typical High $2,041.74 | Facility | None | $281.84 | $794.33 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | None | $269.15 | $302.00 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | None | $269.15 | $269.15 | $288.40 |
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 $147.91 Median $223.87 Typical High $380.19 | Professional | None | $147.91 | $223.87 | $380.19 |
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 $77.62 Median $117.49 Typical High $144.54 | Professional | 52 · Reduced service | $77.62 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $30.90 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $117.49 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $23.44 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $165.96 | $199.53 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,513.56 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $151.36 Typical High $194.98 | Professional | 51 · Multiple procedures | $134.90 | $151.36 | $194.98 |
Where North Carolina sits
The same service costs 8.5 times more in Colorado than in West Virginia. 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 $4,660WV $549
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.