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 $363.08 Median $1,174.90 Typical High $8,317.64 | Facility | None | $363.08 | $1,174.90 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $630.96 | Professional | None | $363.08 | $363.08 | $630.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,202.26 | Professional | None | $407.38 | $616.60 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $389.05 Typical High $588.84 | Facility | None | $363.08 | $389.05 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | None | $245.47 | $354.81 | $354.81 |
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 $288.40 Median $446.68 Typical High $776.25 | Professional | None | $288.40 | $446.68 | $776.25 |
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 $181.97 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $38.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 51 · Multiple procedures | $123.03 | $177.83 | $177.83 |
Where North Carolina sits
The same service costs 7.8 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· 36th of 51
$525
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.