How much rates vary
Facilitymedian $209 · 10th to 90th $107 to $1,000Professionalmedian $275 · 10th to 90th $155 to $537
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 $128.82 Median $213.80 Typical High $4,265.80 | Facility | None | $128.82 | $213.80 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $295.12 | Professional | None | $128.82 | $213.80 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $245.47 Typical High $245.47 | Professional | None | $69.18 | $245.47 | $245.47 |
BCBS North Carolina Setting Facility Modifier None Typical Low $104.71 Median $154.88 Typical High $208.93 | Facility | None | $104.71 | $154.88 | $208.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $588.84 | Professional | None | $218.78 | $331.13 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $1,318.26 | Facility | None | $165.96 | $269.15 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $457.09 | Professional | None | $154.88 | $269.15 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $316.23 Typical High $501.19 | Facility | None | $100.00 | $316.23 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $363.08 | Professional | None | $199.53 | $281.84 | $363.08 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $436.52 | Professional | None | $134.90 | $218.78 | $436.52 |
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 $64.57 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $64.57 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $25.70 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $97.72 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $19.50 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.88 | $19.95 | $22.91 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $46.77 Median $158.49 Typical High $251.19 | Facility | 51 · Multiple procedures | $46.77 | $158.49 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $141.25 Typical High $295.12 | Professional | 51 · Multiple procedures | $100.00 | $141.25 | $295.12 |
Where North Carolina sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.