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 $707.95 Median $1,000.00 Typical High $10,471.29 | Facility | None | $707.95 | $1,000.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | None | $707.95 | $707.95 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5,248.07 Median $8,511.38 Typical High $13,182.57 | Facility | None | $5,248.07 | $8,511.38 | $13,182.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,258.93 | Professional | None | $524.81 | $891.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $12,302.69 | Facility | None | $602.56 | $7,413.10 | $12,302.69 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $8,511.38 | Facility | None | $741.31 | $4,073.80 | $8,511.38 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $1,174.90 | Professional | None | $338.84 | $338.84 | $1,174.90 |
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 $338.84 Median $549.54 Typical High $1,905.46 | Professional | None | $338.84 | $549.54 | $1,905.46 |
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 $354.81 Median $354.81 Typical High $363.08 | Professional | 52 · Reduced service | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 53 · Discontinued | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $72.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $169.82 Typical High $776.25 | Professional | 51 · Multiple procedures | $169.82 | $169.82 | $776.25 |
Where North Carolina sits
The same service costs 14.8 times more in Texas 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· 33rd of 51
$912
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.