How much rates vary
Facilitymedian $2,399 · 10th to 90th $646 to $8,511Professionalmedian $617 · 10th to 90th $427 to $1,096
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 $323.59 Median $1,288.25 Typical High $8,317.64 | Facility | None | $323.59 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $398.11 | Professional | None | $323.59 | $323.59 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,548.82 | $2,290.87 | $3,090.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,096.48 | Professional | None | $457.09 | $707.95 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,754.40 Typical High $8,511.38 | Facility | None | $645.65 | $5,754.40 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $691.83 | Professional | None | $426.58 | $457.09 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | None | $676.08 | $676.08 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $3,630.78 | Facility | None | $575.44 | $977.24 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $602.56 | Professional | None | $309.03 | $512.86 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $630.96 | Professional | None | $309.03 | $407.38 | $630.96 |
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 $162.18 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $38.02 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $616.60 Typical High $1,778.28 | Facility | 51 · Multiple procedures | $295.12 | $616.60 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $154.88 Median $257.04 Typical High $316.23 | Professional | 51 · Multiple procedures | $154.88 | $257.04 | $316.23 |
Where North Carolina sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.