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 $234.42 Median $1,000.00 Typical High $10,471.29 | Facility | None | $234.42 | $1,000.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $524.81 | Professional | None | $223.87 | $234.42 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $5,370.32 | Facility | None | $2,089.30 | $3,467.37 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $741.31 | Professional | None | $331.13 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $5,011.87 | Facility | None | $602.56 | $3,019.95 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $3,090.30 Typical High $6,456.54 | Facility | None | $245.47 | $3,090.30 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $398.11 | Professional | None | $158.49 | $229.09 | $398.11 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $645.65 | Professional | None | $229.09 | $363.08 | $645.65 |
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 $112.20 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $33.11 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.39 | $23.44 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $114.82 Typical High $323.59 | Professional | 51 · Multiple procedures | $79.43 | $114.82 | $323.59 |
Where North Carolina sits
The same service costs 10.7 times more in Colorado 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· 27th of 51
$575
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.