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 $91.20 Median $125.89 Typical High $1,584.89 | Facility | None | $91.20 | $125.89 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $204.17 | Professional | None | $91.20 | $125.89 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $173.78 | Professional | None | $56.23 | $117.49 | $173.78 |
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 $97.72 Median $177.83 Typical High $309.03 | Professional | None | $97.72 | $177.83 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $138.04 Typical High $208.93 | Facility | None | $56.23 | $138.04 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $275.42 | Professional | None | $104.71 | $125.89 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | None | $177.83 | $177.83 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $223.87 | Facility | None | $83.18 | $120.23 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $151.36 | Professional | None | $81.28 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $257.04 | Professional | None | $83.18 | $120.23 | $257.04 |
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 $45.71 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $18.62 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $69.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $77.62 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $64.57 | $77.62 | $89.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $38.90 Median $60.26 Typical High $112.20 | Facility | 51 · Multiple procedures | $38.90 | $60.26 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $75.86 Typical High $81.28 | Professional | 51 · Multiple procedures | $40.74 | $75.86 | $81.28 |
Where North Carolina sits
The same service costs 3.8 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· 29th of 51
$132
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.