How much rates vary
Facilitymedian $1,905 · 10th to 90th $501 to $5,623Professionalmedian $550 · 10th to 90th $372 to $1,072
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 $346.74 Median $436.52 Typical High $7,943.28 | Facility | None | $346.74 | $436.52 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $691.83 | Professional | None | $346.74 | $363.08 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $549.54 | Professional | None | $309.03 | $489.78 | $549.54 |
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 $446.68 Median $741.31 Typical High $1,096.48 | Professional | None | $446.68 | $741.31 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,388.44 | Facility | None | $794.33 | $2,511.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $933.25 | Professional | None | $426.58 | $501.19 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,511.89 | Facility | None | $691.83 | $1,174.90 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,380.38 | Professional | None | $416.87 | $512.86 | $1,380.38 |
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 $354.81 Median $467.74 Typical High $851.14 | Professional | None | $354.81 | $467.74 | $851.14 |
9 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 $169.82 Median $169.82 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $42.66 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $5,495.41 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $5,495.41 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,819.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,071.52 Typical High $2,041.74 | Professional | 50 · Both sides | $691.83 | $1,071.52 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $354.81 Typical High $676.08 | Professional | 51 · Multiple procedures | $229.09 | $354.81 | $676.08 |
Where North Carolina sits
The same service costs 6.1 times more in Wisconsin 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
WI $6,592MT $1,087
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.