How much rates vary
Facilitymedian $1,047 · 10th to 90th $479 to $4,074Professionalmedian $912 · 10th to 90th $269 to $2,138
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 $190.55 Median $891.25 Typical High $7,585.78 | Facility | None | $190.55 | $891.25 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $741.31 Typical High $1,023.29 | Professional | None | $190.55 | $741.31 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $295.12 | Professional | None | $194.98 | $194.98 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $6,606.93 | Facility | None | $1,659.59 | $2,511.89 | $6,606.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $338.84 Median $912.01 Typical High $2,137.96 | Professional | None | $338.84 | $912.01 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $2,290.87 | Facility | None | $602.56 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $676.08 Typical High $1,318.26 | Professional | None | $269.15 | $676.08 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,584.89 | Facility | None | $724.44 | $724.44 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,174.90 | Professional | None | $831.76 | $1,174.90 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | None | $977.24 | $977.24 | $1,023.29 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $199.53 Median $707.95 Typical High $1,230.27 | Professional | None | $199.53 | $707.95 | $1,230.27 |
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 $95.50 Median $338.84 Typical High $446.68 | Professional | 52 · Reduced service | $95.50 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $134.90 Typical High $177.83 | Professional | 53 · Discontinued | $38.02 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $512.86 Typical High $676.08 | Professional | 54 · Surgery only | $141.25 | $512.86 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $102.33 Typical High $134.90 | Professional | 55 · Aftercare only | $28.84 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $67.61 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.05 | $67.61 | $89.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $363.08 Typical High $794.33 | Facility | 51 · Multiple procedures | $363.08 | $363.08 | $794.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $575.44 Typical High $602.56 | Professional | 51 · Multiple procedures | $416.87 | $575.44 | $602.56 |
Where North Carolina sits
The same service costs 5.2 times more in Colorado 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
CO $5,090MD $977
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.