How much rates vary
Facilitymedian $166 · 10th to 90th $68 to $1,738Professionalmedian $174 · 10th to 90th $79 to $331
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 $54.95 Median $87.10 Typical High $7,413.10 | Facility | None | $54.95 | $87.10 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $181.97 | Professional | None | $54.95 | $87.10 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
BCBS North Carolina Setting Facility Modifier None Typical Low $85.11 Median $128.82 Typical High $173.78 | Facility | None | $85.11 | $128.82 | $173.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $346.74 | Professional | None | $93.33 | $186.21 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $93.33 Typical High $524.81 | Facility | None | $60.26 | $93.33 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $234.42 | Professional | None | $79.43 | $134.90 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | None | $208.93 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $177.83 | Facility | None | $66.07 | $151.36 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $251.19 | Professional | None | $100.00 | $165.96 | $251.19 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $213.80 | Professional | None | $54.95 | $93.33 | $213.80 |
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 $27.54 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $10.96 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $64.57 Typical High $67.61 | Professional | 54 · Surgery only | $41.69 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $8.32 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.50 | $8.51 | $8.91 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $104.71 Median $245.47 Typical High $263.03 | Facility | 50 · Both sides | $104.71 | $245.47 | $263.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $34.67 Median $81.28 Typical High $87.10 | Facility | 51 · Multiple procedures | $34.67 | $81.28 | $87.10 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $251.19 Typical High $380.19 | Professional | 50 · Both sides | $181.97 | $251.19 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $83.18 Typical High $125.89 | Professional | 51 · Multiple procedures | $60.26 | $83.18 | $125.89 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 3rd of 51
$174
AK $224KY $69.18
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.