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 $389.05 Median $389.05 Typical High $7,943.28 | Facility | None | $389.05 | $389.05 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $676.08 | Professional | None | $275.42 | $389.05 | $676.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $11,220.18 | Facility | None | $2,818.38 | $4,466.84 | $11,220.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $1,174.90 Typical High $2,187.76 | Professional | None | $100.00 | $1,174.90 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,754.40 | Facility | None | $602.56 | $3,467.37 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $3,467.37 Typical High $7,585.78 | Facility | None | $407.38 | $3,467.37 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $912.01 | Professional | None | $239.88 | $239.88 | $912.01 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,318.26 | Professional | None | $602.56 | $776.25 | $1,318.26 |
6 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 $120.23 Median $194.98 Typical High $331.13 | Professional | 52 · Reduced service | $120.23 | $194.98 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $77.62 Typical High $131.83 | Professional | 53 · Discontinued | $48.98 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $288.40 Typical High $501.19 | Professional | 54 · Surgery only | $181.97 | $288.40 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $57.54 Typical High $100.00 | Professional | 55 · Aftercare only | $36.31 | $57.54 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $38.90 Typical High $66.07 | Professional | 56 · Pre-op care only | $24.55 | $38.90 | $66.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $120.23 Typical High $467.74 | Professional | 51 · Multiple procedures | $120.23 | $120.23 | $467.74 |
Where North Carolina sits
The same service costs 12.6 times more in Ohio than in Nebraska. 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· 31st of 51
$1,047
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.