How much rates vary
Facilitymedian $295 · 10th to 90th $110 to $912Professionalmedian $339 · 10th to 90th $162 to $617
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 $131.83 Median $234.42 Typical High $7,413.10 | Facility | None | $131.83 | $234.42 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $275.42 | Professional | None | $131.83 | $223.87 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $602.56 | Facility | None | $151.36 | $234.42 | $602.56 |
BCBS North Carolina Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $630.96 | Professional | None | $190.55 | $338.84 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $645.65 | Facility | None | $234.42 | $363.08 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $398.11 | Professional | None | $144.54 | $199.53 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $562.34 | Professional | None | $281.84 | $281.84 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $309.03 Typical High $724.44 | Facility | None | $131.83 | $309.03 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $302.00 | Professional | None | $223.87 | $269.15 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | None | $204.17 | $204.17 | $213.80 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $338.84 | Professional | None | $128.82 | $204.17 | $338.84 |
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 $66.07 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $66.07 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $26.92 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $100.00 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $19.95 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $93.33 | $154.88 | $169.82 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $64.57 Median $218.78 Typical High $363.08 | Facility | 51 · Multiple procedures | $64.57 | $218.78 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | 51 · Multiple procedures | $112.20 | $134.90 | $162.18 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 8th of 51
$339
AK $562DC $162
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.