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 $54.95 Median $151.36 Typical High $5,495.41 | Facility | None | $54.95 | $151.36 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $141.25 Typical High $245.47 | Professional | None | $54.95 | $141.25 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | None | $251.19 | $263.03 | $263.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $147.91 Median $218.78 Typical High $295.12 | Facility | None | $147.91 | $218.78 | $295.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $69.18 Median $177.83 Typical High $371.54 | Professional | None | $69.18 | $177.83 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $645.65 | Facility | None | $134.90 | $213.80 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $251.19 | Professional | None | $74.13 | $173.78 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $169.82 Typical High $302.00 | Facility | None | $66.07 | $169.82 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | None | $144.54 | $204.17 | $204.17 |
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 $54.95 Median $125.89 Typical High $239.88 | Professional | None | $54.95 | $125.89 | $239.88 |
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 $27.54 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $27.54 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $10.96 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $41.69 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $8.32 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.50 | $13.18 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $100.00 Typical High $120.23 | Professional | 51 · Multiple procedures | $72.44 | $100.00 | $120.23 |
Where North Carolina sits
The same service costs 2.6 times more in Alaska than in Montana. 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
$174
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.