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 $478.63 Median $1,288.25 Typical High $8,317.64 | Facility | None | $478.63 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $549.54 | Professional | None | $457.09 | $478.63 | $549.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $5,623.41 Typical High $9,120.11 | Facility | None | $3,548.13 | $5,623.41 | $9,120.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,479.11 | Professional | None | $645.65 | $1,071.52 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,079.46 Typical High $11,748.98 | Facility | None | $602.56 | $7,079.46 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $6,760.83 Typical High $14,454.40 | Facility | None | $501.19 | $6,760.83 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $758.58 | Professional | None | $457.09 | $457.09 | $758.58 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,230.27 | Professional | None | $416.87 | $602.56 | $1,230.27 |
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 $229.09 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $338.84 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $48.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $691.83 Typical High $1,380.38 | Professional | 50 · Both sides | $691.83 | $691.83 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | 51 · Multiple procedures | $229.09 | $229.09 | $457.09 |
Where North Carolina sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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· 11th of 51
$1,000
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.