How much rates vary
Facilitymedian $933 · 10th to 90th $316 to $4,365Professionalmedian $661 · 10th to 90th $363 to $1,096
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 $275.42 Median $380.19 Typical High $7,585.78 | Facility | None | $275.42 | $380.19 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $537.03 | Professional | None | $275.42 | $380.19 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,445.44 | Facility | None | $363.08 | $562.34 | $1,445.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,148.15 | Professional | None | $501.19 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $4,570.88 | Facility | None | $645.65 | $3,090.30 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $933.25 | Professional | None | $389.05 | $489.78 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $3,311.31 | Facility | None | $309.03 | $616.60 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $831.76 | Professional | None | $389.05 | $501.19 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $933.25 | Professional | None | $281.84 | $489.78 | $933.25 |
8 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 $138.04 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $54.95 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $34.67 | $38.02 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $257.04 Median $724.44 Typical High $724.44 | Professional | 59 · Distinct service | $257.04 | $724.44 | $724.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $331.13 Typical High $1,659.59 | Facility | 51 · Multiple procedures | $154.88 | $331.13 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $269.15 Typical High $537.03 | Professional | 51 · Multiple procedures | $239.88 | $269.15 | $537.03 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in New York. 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.
North Carolina· 7th of 51
$661
AK $1,380NY $355
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.