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 $102.33 Median $251.19 Typical High $1,584.89 | Facility | None | $102.33 | $251.19 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $380.19 | Professional | None | $102.33 | $208.93 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | None | $141.25 | $141.25 | $181.97 |
BCBS North Carolina Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $309.03 | Facility | None | $77.62 | $120.23 | $309.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $398.11 | Professional | None | $100.00 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $331.13 Typical High $537.03 | Facility | None | $56.23 | $331.13 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $346.74 | Professional | None | $102.33 | $186.21 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | None | $234.42 | $234.42 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $371.54 | Facility | None | $83.18 | $120.23 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $245.47 | Professional | None | $138.04 | $199.53 | $245.47 |
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 $85.11 Median $151.36 Typical High $309.03 | Professional | None | $85.11 | $151.36 | $309.03 |
8 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 $51.29 Median $64.57 Typical High $125.89 | Professional | 52 · Reduced service | $51.29 | $64.57 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $50.12 | Professional | 53 · Discontinued | $20.42 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $97.72 Typical High $186.21 | Professional | 54 · Surgery only | $75.86 | $97.72 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $37.15 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $91.20 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $70.79 | $91.20 | $173.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $38.90 Median $60.26 Typical High $186.21 | Facility | 51 · Multiple procedures | $38.90 | $60.26 | $186.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $100.00 Typical High $141.25 | Professional | 51 · Multiple procedures | $69.18 | $100.00 | $141.25 |
Where North Carolina sits
The same service costs 4.1 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· 30th of 51
$204
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.