How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $6,026Professionalmedian $933 · 10th to 90th $589 to $1,585
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 $588.84 Median $1,288.25 Typical High $10,471.29 | Facility | None | $588.84 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | None | $588.84 | $588.84 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,445.44 | $2,137.96 | $2,884.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,659.59 | Professional | None | $758.58 | $1,047.13 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,467.37 | Facility | None | $794.33 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $1,148.15 | Professional | None | $588.84 | $602.56 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,380.38 | Professional | None | $891.25 | $891.25 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $2,754.23 | Facility | None | $707.95 | $1,148.15 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $776.25 | Professional | None | $562.34 | $707.95 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
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 $501.19 Median $588.84 Typical High $1,096.48 | Professional | None | $501.19 | $588.84 | $1,096.48 |
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 $288.40 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $489.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,778.28 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $281.84 Median $354.81 Typical High $457.09 | Professional | 51 · Multiple procedures | $281.84 | $354.81 | $457.09 |
Where North Carolina sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.