How much rates vary
Facilitymedian $1,096 · 10th to 90th $324 to $2,455Professionalmedian $1,096 · 10th to 90th $158 to $2,692
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 $114.82 Median $1,288.25 Typical High $7,244.36 | Facility | None | $114.82 | $1,288.25 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $831.76 Typical High $1,348.96 | Professional | None | $114.82 | $831.76 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,949.84 | Facility | None | $977.24 | $1,445.44 | $1,949.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $1,122.02 Typical High $2,951.21 | Professional | None | $204.17 | $1,122.02 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,995.26 | Facility | None | $602.56 | $1,230.27 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $416.87 Typical High $1,778.28 | Professional | None | $154.88 | $416.87 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $724.44 Typical High $1,288.25 | Facility | None | $186.21 | $724.44 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $120.23 Median $758.58 Typical High $1,548.82 | Professional | None | $120.23 | $758.58 | $1,548.82 |
6 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 $57.54 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $57.54 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $204.17 Typical High $257.04 | Professional | 53 · Discontinued | $22.91 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $87.10 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $17.38 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $11.48 | $102.33 | $128.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 51 · Multiple procedures | $588.84 | $660.69 | $660.69 |
Where North Carolina sits
The same service costs 5.5 times more in Hawaii than in Maryland. 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
HI $4,440MD $808
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.