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 $123.03 Median $1,000.00 Typical High $7,943.28 | Facility | None | $123.03 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $758.58 | Facility | None | $295.12 | $489.78 | $758.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $3,801.89 | Professional | None | $177.83 | $323.59 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $912.01 | Facility | None | $363.08 | $537.03 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $524.81 Typical High $1,096.48 | Facility | None | $128.82 | $524.81 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $512.86 | Professional | None | $120.23 | $120.23 | $512.86 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $416.87 | Professional | None | $154.88 | $208.93 | $416.87 |
5 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 $57.54 Median $61.66 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $26.30 | Professional | 53 · Discontinued | $22.91 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $13.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $60.26 Typical High $177.83 | Professional | 51 · Multiple procedures | $60.26 | $60.26 | $177.83 |
Where North Carolina sits
The same service costs 24.5 times more in Texas than in Missouri. 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
$316
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.