How much rates vary
Facilitymedian $1,738 · 10th to 90th $537 to $5,623Professionalmedian $646 · 10th to 90th $229 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 $169.82 Median $741.31 Typical High $7,244.36 | Facility | None | $169.82 | $741.31 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $660.69 Typical High $891.25 | Professional | None | $169.82 | $660.69 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $5,754.40 | Facility | None | $1,445.44 | $2,187.76 | $5,754.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $645.65 Typical High $3,019.95 | Professional | None | $295.12 | $645.65 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,388.44 | Facility | None | $602.56 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $758.58 Typical High $1,819.70 | Professional | None | $229.09 | $758.58 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $2,511.89 | Facility | None | $371.54 | $977.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,202.26 | Professional | None | $616.60 | $776.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $177.83 Median $602.56 Typical High $1,778.28 | Professional | None | $177.83 | $602.56 | $1,778.28 |
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 $85.11 Median $158.49 Typical High $389.05 | Professional | 52 · Reduced service | $85.11 | $158.49 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $63.10 Typical High $154.88 | Professional | 53 · Discontinued | $33.88 | $63.10 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $588.84 | Professional | 54 · Surgery only | $128.82 | $234.42 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $47.86 Typical High $117.49 | Professional | 55 · Aftercare only | $25.70 | $47.86 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $31.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $16.98 | $31.62 | $77.62 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $575.44 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $263.03 | $575.44 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $389.05 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $309.03 | $389.05 | $1,000.00 |
Where North Carolina sits
The same service costs 4.0 times more in Colorado 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
CO $5,041MT $1,267
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.