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 $331.13 Median $1,000.00 Typical High $10,471.29 | Facility | None | $331.13 | $1,000.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $741.31 | Professional | None | $331.13 | $331.13 | $741.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $7,585.78 Median $12,302.69 Typical High $19,498.45 | Facility | None | $7,585.78 | $12,302.69 | $19,498.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,047.13 | Professional | None | $467.74 | $758.58 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,964.78 Typical High $18,197.01 | Facility | None | $602.56 | $10,964.78 | $18,197.01 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $12,882.50 Typical High $26,915.35 | Facility | None | $354.81 | $12,882.50 | $26,915.35 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $588.84 | Professional | None | $229.09 | $323.59 | $588.84 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $1,000.00 | Professional | None | $323.59 | $501.19 | $1,000.00 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $162.18 Typical High $457.09 | Professional | 51 · Multiple procedures | $112.20 | $162.18 | $457.09 |
Where North Carolina sits
The same service costs 15.8 times more in Arkansas than in Maine. 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· 26th of 51
$813
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.