How much rates vary
Facilitymedian $1,148 · 10th to 90th $288 to $4,898Professionalmedian $417 · 10th to 90th $245 to $813
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 $331.13 Median $363.08 Typical High $7,244.36 | Facility | None | $331.13 | $363.08 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $407.38 | Professional | None | $263.03 | $331.13 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $204.17 Median $302.00 Typical High $407.38 | Facility | None | $204.17 | $302.00 | $407.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $831.76 | Professional | None | $302.00 | $478.63 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $3,388.44 | Facility | None | $602.56 | $2,137.96 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $562.34 | Professional | None | $194.98 | $223.87 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $794.33 | Professional | None | $316.23 | $316.23 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $1,862.09 | Facility | None | $275.42 | $398.11 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $371.54 | Professional | None | $275.42 | $316.23 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | None | $239.88 | $239.88 | $251.19 |
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 $208.93 Median $281.84 Typical High $478.63 | Professional | None | $208.93 | $281.84 | $478.63 |
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 $165.96 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $245.47 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $257.04 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $128.82 Median $199.53 Typical High $977.24 | Facility | 51 · Multiple procedures | $128.82 | $199.53 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $158.49 Typical High $199.53 | Professional | 51 · Multiple procedures | $138.04 | $158.49 | $199.53 |
Where North Carolina sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.