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 $1,148.15 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,202.26 | $1,380.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,019.95 Median $4,466.84 Typical High $6,309.57 | Facility | None | $3,019.95 | $4,466.84 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $2,344.23 Typical High $4,073.80 | Professional | None | $100.00 | $2,344.23 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,288.25 | $3,801.89 | $8,511.38 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,137.96 | $2,884.03 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,905.46 | $3,235.94 |
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 $602.56 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $125.89 |
Where North Carolina sits
The same service costs 109.6 times more in Alaska 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· 12th of 51
$2,138
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.