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 $457.09 Median $1,584.89 Typical High $10,964.78 | Facility | None | $457.09 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $1,584.89 | Professional | None | $416.87 | $457.09 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,511.38 Median $11,748.98 Typical High $37,153.52 | Facility | None | $8,511.38 | $11,748.98 | $37,153.52 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $1,819.70 | Professional | None | $812.83 | $1,348.96 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $21,379.62 Typical High $35,481.34 | Facility | None | $602.56 | $21,379.62 | $35,481.34 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $10,471.29 Typical High $23,442.29 | Facility | None | $489.78 | $10,471.29 | $23,442.29 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $933.25 | Professional | None | $288.40 | $416.87 | $933.25 |
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 $602.56 Median $954.99 Typical High $1,380.38 | Professional | None | $602.56 | $954.99 | $1,380.38 |
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 $204.17 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $45.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $208.93 Typical High $630.96 | Professional | 51 · Multiple procedures | $144.54 | $208.93 | $630.96 |
Where North Carolina sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 28th of 51
$1,318
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.