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 $346.74 Median $1,148.15 Typical High $7,943.28 | Facility | None | $346.74 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | None | $346.74 | $346.74 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $4,677.35 | Facility | None | $2,344.23 | $3,467.37 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $1,071.52 | Professional | None | $457.09 | $776.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,754.40 | Facility | None | $602.56 | $3,467.37 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $3,019.95 Typical High $6,760.83 | Facility | None | $416.87 | $3,019.95 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $537.03 | Professional | None | $331.13 | $331.13 | $537.03 |
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 $309.03 Median $446.68 Typical High $977.24 | Professional | None | $309.03 | $446.68 | $977.24 |
7 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 $173.78 Typical High $186.21 | Professional | 52 · Reduced service | $173.78 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $257.04 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $37.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $977.24 | Professional | 50 · Both sides | $489.78 | $489.78 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $165.96 Typical High $323.59 | Professional | 51 · Multiple procedures | $165.96 | $165.96 | $323.59 |
Where North Carolina sits
The same service costs 28.2 times more in Texas than in Kentucky. 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· 11th of 51
$741
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.