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 $104.71 Median $154.88 Typical High $3,548.13 | Facility | None | $104.71 | $154.88 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $245.47 | Professional | None | $104.71 | $154.88 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $190.55 | Professional | None | $67.61 | $138.04 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $190.55 | Facility | None | $93.33 | $138.04 | $190.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $331.13 | Professional | None | $109.65 | $158.49 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $524.81 | Facility | None | $125.89 | $194.98 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $331.13 | Professional | None | $114.82 | $154.88 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $218.78 | Professional | None | $151.36 | $151.36 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $177.83 Typical High $269.15 | Facility | None | $114.82 | $177.83 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $218.78 | Professional | None | $147.91 | $181.97 | $218.78 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $295.12 | Professional | None | $95.50 | $144.54 | $295.12 |
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 $52.48 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $100.00 Typical High $117.49 | Professional | 54 · Surgery only | $79.43 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $93.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $74.13 | $93.33 | $109.65 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $56.23 Median $89.13 Typical High $134.90 | Facility | 51 · Multiple procedures | $56.23 | $89.13 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $91.20 Typical High $123.03 | Professional | 51 · Multiple procedures | $74.13 | $91.20 | $123.03 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$158
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.