How much rates vary
Facilitymedian $3,020 · 10th to 90th $617 to $8,318Professionalmedian $631 · 10th to 90th $417 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 $8,128.31 | Facility | None | $380.19 | $512.86 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $794.33 | Professional | None | $380.19 | $389.05 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $691.83 | Professional | None | $467.74 | $549.54 | $691.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,995.26 Median $2,884.03 Typical High $3,981.07 | Facility | None | $1,995.26 | $2,884.03 | $3,981.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,258.93 | Professional | None | $524.81 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,715.35 Typical High $5,370.32 | Facility | None | $794.33 | $3,715.35 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $1,047.13 | Professional | None | $489.78 | $549.54 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $3,801.89 | Facility | None | $707.95 | $1,698.24 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,513.56 | Professional | None | $457.09 | $588.84 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,388.44 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,388.44 | $15,848.93 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $954.99 | Professional | None | $389.05 | $537.03 | $954.99 |
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 $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 50 · Both sides Typical Low $1,096.48 Median $2,511.89 Typical High $7,762.47 | Facility | 50 · Both sides | $1,096.48 | $2,511.89 | $7,762.47 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $851.14 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $363.08 | $851.14 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,230.27 Typical High $2,238.72 | Professional | 50 · Both sides | $776.25 | $1,230.27 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $407.38 Typical High $758.58 | Professional | 51 · Multiple procedures | $257.04 | $407.38 | $758.58 |
Where North Carolina sits
The same service costs 7.3 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 $8,816MT $1,205
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.