How much rates vary
Facilitymedian $525 · 10th to 90th $240 to $2,692Professionalmedian $269 · 10th to 90th $85 to $603
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 $74.13 Median $281.84 Typical High $5,248.07 | Facility | None | $74.13 | $281.84 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $218.78 Typical High $316.23 | Professional | None | $74.13 | $218.78 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | None | $83.18 | $93.33 | $93.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $691.83 | Facility | None | $173.78 | $269.15 | $691.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $269.15 Typical High $645.65 | Professional | None | $107.15 | $269.15 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $831.76 | Facility | None | $309.03 | $489.78 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $199.53 Typical High $398.11 | Professional | None | $57.54 | $199.53 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $676.08 | Professional | None | $263.03 | $263.03 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $446.68 Typical High $724.44 | Facility | None | $208.93 | $446.68 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $251.19 Typical High $281.84 | Professional | None | $81.28 | $251.19 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $436.52 | Professional | None | $72.44 | $109.65 | $436.52 |
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 $63.10 Median $173.78 Typical High $323.59 | Professional | None | $63.10 | $173.78 | $323.59 |
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 $37.15 Median $95.50 Typical High $141.25 | Professional | 52 · Reduced service | $37.15 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $14.79 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $54.95 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $10.96 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $19.50 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.41 | $19.50 | $28.18 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $104.71 Median $263.03 Typical High $363.08 | Facility | 51 · Multiple procedures | $104.71 | $263.03 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $125.89 Typical High $151.36 | Professional | 51 · Multiple procedures | $40.74 | $125.89 | $151.36 |
Where North Carolina sits
The same service costs 9.0 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 $4,579MT $507
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.