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 $229.09 Median $331.13 Typical High $7,585.78 | Facility | None | $229.09 | $331.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $524.81 | Professional | None | $229.09 | $331.13 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $724.44 | Professional | None | $234.42 | $323.59 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,819.70 | Facility | None | $602.56 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $724.44 | Professional | None | $223.87 | $302.00 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | None | $426.58 | $426.58 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $1,479.11 | Facility | None | $371.54 | $707.95 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $436.52 | Professional | None | $281.84 | $398.11 | $436.52 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $645.65 | Professional | None | $199.53 | $309.03 | $645.65 |
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 $114.82 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $114.82 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $45.71 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $173.78 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $22.91 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $162.18 | $199.53 | $229.09 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $398.11 Typical High $724.44 | Facility | 51 · Multiple procedures | $263.03 | $398.11 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $199.53 Typical High $295.12 | Professional | 51 · Multiple procedures | $138.04 | $199.53 | $295.12 |
Where North Carolina sits
The same service costs 4.0 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· 35th of 51
$331
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.