How much rates vary
Facilitymedian $501 · 10th to 90th $275 to $1,862Professionalmedian $550 · 10th to 90th $282 to $977
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 $181.97 Median $338.84 Typical High $3,548.13 | Facility | None | $181.97 | $338.84 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $446.68 | Professional | None | $181.97 | $309.03 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $1,819.70 | Facility | None | $457.09 | $691.83 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $1,000.00 | Professional | None | $331.13 | $575.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $501.19 Typical High $1,737.80 | Facility | None | $467.74 | $501.19 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | None | $302.00 | $302.00 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $562.34 Typical High $977.24 | Facility | None | $371.54 | $562.34 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $512.86 | Professional | None | $229.09 | $436.52 | $512.86 |
Oscar Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $2,691.53 | Facility | None | $575.44 | $575.44 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $478.63 | Professional | None | $446.68 | $446.68 | $478.63 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,691.53 | Facility | None | $288.40 | $501.19 | $2,691.53 |
United Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $512.86 | Professional | None | $186.21 | $316.23 | $512.86 |
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 Facility Modifier 53 · Discontinued Typical Low $36.31 Median $91.20 Typical High $199.53 | Facility | 53 · Discontinued | $36.31 | $91.20 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $169.82 | Professional | 52 · Reduced service | $89.13 | $89.13 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $72.44 Typical High $169.82 | Professional | 53 · Discontinued | $36.31 | $72.44 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $173.78 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $51.29 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $33.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $194.98 Median $302.00 Typical High $537.03 | Facility | 51 · Multiple procedures | $194.98 | $302.00 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $213.80 Typical High $263.03 | Professional | 51 · Multiple procedures | $114.82 | $213.80 | $263.03 |
Where North Carolina sits
The same service costs 4.3 times more in Connecticut than in West 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.
Physician feeFacility fee
CT $2,910WV $682
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.