How much rates vary
Facilitymedian $1,995 · 10th to 90th $562 to $6,457Professionalmedian $851 · 10th to 90th $447 to $1,259
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 $380.19 Median $512.86 Typical High $7,762.47 | Facility | None | $380.19 | $512.86 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $870.96 | Professional | None | $380.19 | $389.05 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $776.25 | Professional | None | $616.60 | $691.83 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,089.30 | $2,818.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,412.54 | Professional | None | $575.44 | $891.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,047.13 | Professional | None | $501.19 | $602.56 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $3,801.89 | Facility | None | $575.44 | $977.24 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $912.01 | Professional | None | $467.74 | $691.83 | $912.01 |
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 $389.05 Median $575.44 Typical High $977.24 | Professional | None | $389.05 | $575.44 | $977.24 |
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 $190.55 Median $190.55 Typical High $234.42 | Professional | 52 · Reduced service | $190.55 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $75.86 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $354.81 | Professional | 54 · Surgery only | $281.84 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $47.86 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $588.84 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $295.12 | $588.84 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $380.19 Typical High $575.44 | Professional | 51 · Multiple procedures | $257.04 | $380.19 | $575.44 |
Where North Carolina sits
The same service costs 6.4 times more in Alaska 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
AK $7,574MT $1,191
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.