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 $794.33 Median $1,288.25 Typical High $10,471.29 | Facility | None | $794.33 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $794.33 Typical High $1,288.25 | Professional | None | $354.81 | $794.33 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,456.54 Median $8,912.51 Typical High $28,183.83 | Facility | None | $6,456.54 | $8,912.51 | $28,183.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,778.28 Typical High $2,454.71 | Professional | None | $954.99 | $1,778.28 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,232.93 Typical High $16,982.44 | Facility | None | $602.56 | $10,232.93 | $16,982.44 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $8,912.51 Typical High $19,952.62 | Facility | None | $831.76 | $8,912.51 | $19,952.62 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,148.15 | Professional | None | $537.03 | $776.25 | $1,148.15 |
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 $794.33 Median $1,122.02 Typical High $1,584.89 | Professional | None | $794.33 | $1,122.02 | $1,584.89 |
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 $173.78 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $173.78 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $69.18 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $263.03 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $52.48 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $34.67 | $79.43 | $79.43 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $389.05 Typical High $691.83 | Professional | 51 · Multiple procedures | $269.15 | $389.05 | $691.83 |
Where North Carolina sits
The same service costs 16.2 times more in Arkansas 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· 25th of 51
$1,622
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.