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 $741.31 Median $1,288.25 Typical High $8,317.64 | Facility | None | $741.31 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | None | $741.31 | $741.31 | $851.14 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,630.27 Median $4,265.80 Typical High $6,760.83 | Facility | None | $2,630.27 | $4,265.80 | $6,760.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,513.56 Typical High $2,290.87 | Professional | None | $776.25 | $1,513.56 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,754.40 Typical High $9,549.93 | Facility | None | $602.56 | $5,754.40 | $9,549.93 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $7,762.47 | Facility | None | $1,174.90 | $2,691.53 | $7,762.47 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | None | $537.03 | $707.95 | $707.95 |
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 $645.65 Median $912.01 Typical High $1,584.89 | Professional | None | $645.65 | $912.01 | $1,584.89 |
7 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 $371.54 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $75.86 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,348.96 Typical High $3,890.45 | Facility | 51 · Multiple procedures | $1,348.96 | $1,348.96 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $354.81 Typical High $354.81 | Professional | 51 · Multiple procedures | $269.15 | $354.81 | $354.81 |
Where North Carolina sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 14th of 51
$1,514
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.