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 $275.42 Median $380.19 Typical High $7,244.36 | Facility | None | $275.42 | $380.19 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $616.60 | Professional | None | $275.42 | $380.19 | $616.60 |
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 $288.40 Median $389.05 Typical High $851.14 | Professional | None | $288.40 | $389.05 | $851.14 |
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 $295.12 Median $389.05 Typical High $831.76 | Professional | None | $295.12 | $389.05 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $1,288.25 | Facility | None | $436.52 | $707.95 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $602.56 | Professional | None | $363.08 | $467.74 | $602.56 |
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 $239.88 Median $363.08 Typical High $758.58 | Professional | None | $239.88 | $363.08 | $758.58 |
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 $138.04 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $204.17 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $263.03 |
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 $181.97 Median $234.42 Typical High $316.23 | Professional | 51 · Multiple procedures | $181.97 | $234.42 | $316.23 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$389
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.