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 $151.36 Typical High $2,630.27 | Facility | None | $102.33 | $151.36 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $245.47 | Professional | None | $102.33 | $151.36 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $263.03 | Professional | None | $72.44 | $131.83 | $263.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $186.21 | Facility | None | $93.33 | $138.04 | $186.21 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $316.23 | Professional | None | $100.00 | $144.54 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $524.81 | Facility | None | $128.82 | $199.53 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $309.03 | Professional | None | $102.33 | $144.54 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $199.53 | Professional | None | $134.90 | $134.90 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $173.78 Typical High $275.42 | Facility | None | $112.20 | $173.78 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $213.80 | Professional | None | $138.04 | $173.78 | $213.80 |
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 $87.10 Median $134.90 Typical High $275.42 | Professional | None | $87.10 | $134.90 | $275.42 |
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 $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $20.42 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $75.86 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $89.13 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $70.79 | $89.13 | $107.15 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $56.23 Median $87.10 Typical High $138.04 | Facility | 51 · Multiple procedures | $56.23 | $87.10 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $85.11 Typical High $117.49 | Professional | 51 · Multiple procedures | $69.18 | $85.11 | $117.49 |
Where North Carolina sits
The same service costs 3.7 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· 32nd of 51
$148
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.