How much rates vary
Facilitymedian $1,380 · 10th to 90th $398 to $5,129Professionalmedian $417 · 10th to 90th $234 to $794
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 $194.98 Median $346.74 Typical High $7,244.36 | Facility | None | $194.98 | $346.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $389.05 | Professional | None | $194.98 | $309.03 | $389.05 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $5,754.40 | Facility | None | $1,445.44 | $2,238.72 | $5,754.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $831.76 | Professional | None | $295.12 | $501.19 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $1,995.26 | Facility | None | $602.56 | $1,621.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $676.08 | Professional | None | $234.42 | $346.74 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $1,412.54 | Facility | None | $371.54 | $977.24 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $575.44 | Professional | None | $331.13 | $380.19 | $575.44 |
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 $199.53 Median $323.59 Typical High $691.83 | Professional | None | $199.53 | $323.59 | $691.83 |
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 $97.72 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $97.72 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $70.79 | Professional | 53 · Discontinued | $38.90 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $144.54 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $34.67 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $575.44 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $257.04 | $575.44 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $229.09 Typical High $457.09 | Professional | 51 · Multiple procedures | $165.96 | $229.09 | $457.09 |
Where North Carolina sits
The same service costs 7.9 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 $5,867MT $745
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.