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 $120.23 Median $194.98 Typical High $7,413.10 | Facility | None | $120.23 | $194.98 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $229.09 | Professional | None | $120.23 | $181.97 | $229.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $501.19 | Facility | None | $125.89 | $194.98 | $501.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $407.38 | Professional | None | $112.20 | $181.97 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $524.81 | Facility | None | $162.18 | $257.04 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $363.08 | Professional | None | $97.72 | $165.96 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | None | $181.97 | $181.97 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $354.81 | Facility | None | $147.91 | $229.09 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $239.88 | Professional | None | $151.36 | $223.87 | $239.88 |
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 $102.33 Median $162.18 Typical High $331.13 | Professional | None | $102.33 | $162.18 | $331.13 |
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 $58.88 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $58.88 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $38.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $114.82 Typical High $144.54 | Professional | 54 · Surgery only | $89.13 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $17.78 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $107.15 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $83.18 | $107.15 | $134.90 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $74.13 Median $114.82 Typical High $177.83 | Facility | 51 · Multiple procedures | $74.13 | $114.82 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $112.20 Typical High $138.04 | Professional | 51 · Multiple procedures | $75.86 | $112.20 | $138.04 |
Where North Carolina sits
The same service costs 3.6 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· 33rd of 51
$186
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.