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 $218.78 Median $275.42 Typical High $7,413.10 | Facility | None | $218.78 | $275.42 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $467.74 | Professional | None | $218.78 | $275.42 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $891.25 | Facility | None | $446.68 | $660.69 | $891.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $645.65 | Professional | None | $223.87 | $281.84 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,479.11 | Facility | None | $457.09 | $1,202.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $616.60 | Professional | None | $245.47 | $295.12 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | None | $331.13 | $331.13 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $1,071.52 | Facility | None | $331.13 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $354.81 | Professional | None | $269.15 | $331.13 | $354.81 |
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 $190.55 Median $269.15 Typical High $602.56 | Professional | None | $190.55 | $269.15 | $602.56 |
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 $109.65 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $109.65 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $43.65 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.88 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $154.88 | $169.82 | $194.98 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $177.83 Median $275.42 Typical High $724.44 | Facility | 51 · Multiple procedures | $177.83 | $275.42 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $165.96 Typical High $223.87 | Professional | 51 · Multiple procedures | $131.83 | $165.96 | $223.87 |
Where North Carolina sits
The same service costs 3.9 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· 34th of 51
$295
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.