How much rates vary
Facilitymedian $2,399 · 10th to 90th $912 to $6,457Professionalmedian $1,380 · 10th to 90th $447 to $3,548
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 $1,348.96 Typical High $7,943.28 | Facility | None | $331.13 | $1,348.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,288.25 Typical High $1,548.82 | Professional | None | $331.13 | $1,288.25 | $1,548.82 |
BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $3,311.31 | Facility | None | $1,659.59 | $2,454.71 | $3,311.31 |
BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,905.46 Typical High $3,890.45 | Professional | None | $562.34 | $1,905.46 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,570.40 Typical High $4,168.69 | Facility | None | $602.56 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,174.90 Typical High $2,754.23 | Professional | None | $457.09 | $1,174.90 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $1,621.81 Typical High $3,630.78 | Facility | None | $537.03 | $1,621.81 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,905.46 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $346.74 Median $1,174.90 Typical High $2,691.53 | Professional | None | $346.74 | $1,174.90 | $2,691.53 |
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 $165.96 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $165.96 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $245.47 Typical High $302.00 | Professional | 53 · Discontinued | $66.07 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $912.01 Typical High $1,148.15 | Professional | 54 · Surgery only | $251.19 | $912.01 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $181.97 Typical High $229.09 | Professional | 55 · Aftercare only | $50.12 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $33.11 | $123.03 | $151.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,884.03 Typical High $5,754.40 | Professional | 50 · Both sides | $2,511.89 | $2,884.03 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $954.99 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $831.76 | $954.99 | $1,905.46 |
Where North Carolina sits
The same service costs 3.8 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 $8,346MT $2,210
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.