How much rates vary
Facilitymedian $166 · 10th to 90th $83 to $1,585Professionalmedian $195 · 10th to 90th $95 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 $53.70 Median $109.65 Typical High $5,495.41 | Facility | None | $53.70 | $109.65 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $208.93 | Professional | None | $53.70 | $109.65 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $223.87 | Professional | None | $120.23 | $120.23 | $223.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $131.83 | Facility | None | $64.57 | $97.72 | $131.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $346.74 | Professional | None | $112.20 | $194.98 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $524.81 | Facility | None | $100.00 | $158.49 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $263.03 | Professional | None | $102.33 | $147.91 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $194.98 | Facility | None | $79.43 | $123.03 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $213.80 | Professional | None | $128.82 | $162.18 | $213.80 |
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 $53.70 Median $117.49 Typical High $229.09 | Professional | None | $53.70 | $117.49 | $229.09 |
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 $26.92 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $26.92 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $10.72 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $79.43 Typical High $81.28 | Professional | 54 · Surgery only | $40.74 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $15.85 Typical High $16.22 | Professional | 55 · Aftercare only | $8.13 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.72 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.37 | $10.72 | $10.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $186.21 Typical High $288.40 | Facility | 50 · Both sides | $117.49 | $186.21 | $288.40 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $39.81 Median $61.66 Typical High $97.72 | Facility | 51 · Multiple procedures | $39.81 | $61.66 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $239.88 Typical High $436.52 | Professional | 50 · Both sides | $194.98 | $239.88 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $79.43 Typical High $144.54 | Professional | 51 · Multiple procedures | $64.57 | $79.43 | $144.54 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Virginia. 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
$195
AK $263VA $81.28
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.