How much rates vary
Facilitymedian $355 · 10th to 90th $204 to $1,318Professionalmedian $363 · 10th to 90th $204 to $692
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 $190.55 Median $281.84 Typical High $2,630.27 | Facility | None | $190.55 | $281.84 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $398.11 | Professional | None | $190.55 | $281.84 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $416.87 | Professional | None | $234.42 | $275.42 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $162.18 Median $239.88 Typical High $331.13 | Facility | None | $162.18 | $239.88 | $331.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $707.95 | Professional | None | $234.42 | $416.87 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $407.38 Typical High $707.95 | Facility | None | $281.84 | $407.38 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $467.74 | Professional | None | $173.78 | $208.93 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $676.08 | Professional | None | $302.00 | $302.00 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $371.54 Typical High $724.44 | Facility | None | $204.17 | $371.54 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $323.59 | Professional | None | $213.80 | $269.15 | $323.59 |
Oscar Health Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,023.29 | Facility | None | $269.15 | $269.15 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | None | $177.83 | $177.83 | $190.55 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $416.87 | Professional | None | $177.83 | $229.09 | $416.87 |
9 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 $95.50 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $95.50 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $38.02 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $141.25 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $28.84 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.05 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $204.17 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 51 · Multiple procedures | $275.42 | $275.42 | $275.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $102.33 Median $245.47 Typical High $363.08 | Facility | 51 · Multiple procedures | $102.33 | $245.47 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $131.83 Typical High $190.55 | Professional | 51 · Multiple procedures | $107.15 | $131.83 | $190.55 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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.
North Carolina· 12th of 51
$363
AK $776KY $204
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.