How much rates vary
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 $1,148.15 Median $1,445.44 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,445.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,445.44 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,715.35 Median $5,754.40 Typical High $14,791.08 | Facility | None | $3,715.35 | $5,754.40 | $14,791.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $1,445.44 Typical High $2,630.27 | Professional | None | $100.00 | $1,445.44 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $17,378.01 Typical High $28,840.32 | Facility | None | $602.56 | $17,378.01 | $28,840.32 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $54,954.09 | Facility | None | $1,621.81 | $1,621.81 | $54,954.09 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $19,498.45 Typical High $45,708.82 | Facility | None | $2,238.72 | $19,498.45 | $45,708.82 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,445.44 | $2,089.30 |
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 $691.83 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $144.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $2,398.83 Median $2,398.83 Typical High $83,176.38 | Facility | 50 · Both sides | $2,398.83 | $2,398.83 | $83,176.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $794.33 Median $794.33 Typical High $27,542.29 | Facility | 51 · Multiple procedures | $794.33 | $794.33 | $27,542.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,089.30 Typical High $2,089.30 | Professional | 50 · Both sides | $1,479.11 | $2,089.30 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $691.83 Typical High $691.83 | Professional | 51 · Multiple procedures | $501.19 | $691.83 | $691.83 |
Where North Carolina sits
The same service costs 6.9 times more in Arkansas 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· 44th of 51
$1,445
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.