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 $1,000.00 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,388.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,388.44 Typical High $3,801.89 | Professional | None | $3,162.28 | $3,388.44 | $3,801.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,621.81 | Facility | None | $794.33 | $1,174.90 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,981.07 Median $7,762.47 Typical High $11,220.18 | Professional | None | $3,981.07 | $7,762.47 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,949.84 | Facility | None | $602.56 | $1,122.02 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $4,073.80 | Facility | None | $1,071.52 | $2,290.87 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,290.87 | $2,884.03 | $4,897.79 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $8,128.31 | Professional | None | $3,467.37 | $4,677.35 | $8,128.31 |
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 $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,621.81 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,454.71 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $323.59 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,445.44 Typical High $4,466.84 | Professional | 51 · Multiple procedures | $1,148.15 | $1,445.44 | $4,466.84 |
Where North Carolina sits
The same service costs 3.5 times more in Indiana than in Maryland. 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· 3rd of 51
$4,898
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.