How much rates vary
Facilitymedian $110 · 10th to 90th $72 to $851Professionalmedian $224 · 10th to 90th $110 to $339
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 $89.13 Median $109.65 Typical High $7,413.10 | Facility | None | $89.13 | $109.65 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $245.47 | Professional | None | $89.13 | $109.65 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | None | $109.65 | $109.65 | $125.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $58.88 Median $85.11 Typical High $114.82 | Facility | None | $58.88 | $85.11 | $114.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $354.81 | Professional | None | $162.18 | $281.84 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $117.49 Typical High $524.81 | Facility | None | $75.86 | $117.49 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $257.04 | Professional | None | $128.82 | $177.83 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $173.78 | Facility | None | $66.07 | $83.18 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $630.96 | Professional | None | $154.88 | $323.59 | $630.96 |
Oscar Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $2,137.96 | Facility | None | $102.33 | $102.33 | $2,137.96 |
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 $95.50 Median $169.82 Typical High $257.04 | Professional | None | $95.50 | $169.82 | $257.04 |
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 $43.65 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $43.65 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $17.78 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $66.07 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $13.18 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.91 | $10.96 | $12.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $81.28 Median $125.89 Typical High $208.93 | Facility | 50 · Both sides | $81.28 | $125.89 | $208.93 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $26.92 Median $41.69 Typical High $69.18 | Facility | 51 · Multiple procedures | $26.92 | $41.69 | $69.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $501.19 Typical High $954.99 | Professional | 50 · Both sides | $229.09 | $501.19 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $165.96 Typical High $316.23 | Professional | 51 · Multiple procedures | $77.62 | $165.96 | $316.23 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$209
AK $363FL $97.72
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.