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 $549.54 Median $1,288.25 Typical High $8,317.64 | Facility | None | $549.54 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $1,288.25 | Professional | None | $323.59 | $549.54 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,265.80 | Facility | None | $2,187.76 | $3,162.28 | $4,265.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,698.24 | Professional | None | $707.95 | $1,230.27 | $1,698.24 |
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 $588.84 Median $2,691.53 Typical High $6,456.54 | Facility | None | $588.84 | $2,691.53 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $794.33 | Professional | None | $371.54 | $537.03 | $794.33 |
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 $549.54 Median $812.83 Typical High $1,288.25 | Professional | None | $549.54 | $812.83 | $1,288.25 |
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 $158.49 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $63.10 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $239.88 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $47.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $31.62 | $54.95 | $54.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $269.15 Typical High $489.78 | Professional | 51 · Multiple procedures | $186.21 | $269.15 | $489.78 |
Where North Carolina sits
The same service costs 10.2 times more in Texas 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· 24th of 51
$1,230
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.