How much rates vary
Facilitymedian $1,622 · 10th to 90th $398 to $5,248Professionalmedian $501 · 10th to 90th $209 to $1,380
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 $177.83 Median $537.03 Typical High $7,413.10 | Facility | None | $177.83 | $537.03 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $501.19 Typical High $645.65 | Professional | None | $177.83 | $501.19 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,862.09 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $263.03 Median $537.03 Typical High $1,479.11 | Professional | None | $263.03 | $537.03 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,905.46 Typical High $2,818.38 | Facility | None | $457.09 | $1,905.46 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $501.19 Typical High $794.33 | Professional | None | $190.55 | $501.19 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,348.96 | Professional | None | $676.08 | $676.08 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,041.74 | Facility | None | $371.54 | $776.25 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $602.56 | Professional | None | $446.68 | $512.86 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | None | $331.13 | $331.13 | $346.74 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $691.83 | Professional | None | $173.78 | $416.87 | $691.83 |
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 $87.10 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $87.10 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $35.48 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $131.83 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $26.30 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $17.78 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $123.03 | $323.59 | $380.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $436.52 Typical High $1,513.56 | Facility | 51 · Multiple procedures | $186.21 | $436.52 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $257.04 Typical High $302.00 | Professional | 51 · Multiple procedures | $223.87 | $257.04 | $302.00 |
Where North Carolina sits
The same service costs 4.4 times more in Colorado than in North Dakota. 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 $4,844ND $1,099
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.