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 $10.00 Median $21.88 Typical High $7,413.10 | Facility | None | $10.00 | $21.88 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $21.88 Typical High $51.29 | Professional | None | $10.00 | $21.88 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $10.23 Median $40.74 Typical High $44.67 | Professional | None | $10.23 | $40.74 | $44.67 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19.05 Median $28.84 Typical High $75.86 | Facility | None | $19.05 | $28.84 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $17.38 Median $34.67 Typical High $72.44 | Professional | None | $17.38 | $34.67 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $50.12 | Professional | None | $19.95 | $30.20 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $35.48 Typical High $35.48 | Facility | None | $21.88 | $35.48 | $35.48 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $38.02 | Professional | None | $28.18 | $37.15 | $38.02 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $13.49 Median $25.70 Typical High $48.98 | Professional | None | $13.49 | $25.70 | $48.98 |
7 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 $5.01 Median $10.72 Typical High $10.96 | Professional | 52 · Reduced service | $5.01 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $4.27 Typical High $4.37 | Professional | 53 · Discontinued | $2.04 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $15.85 Typical High $16.60 | Professional | 54 · Surgery only | $7.59 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $3.24 Typical High $3.31 | Professional | 55 · Aftercare only | $1.51 | $3.24 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $2.14 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.00 | $2.14 | $2.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $11.48 Median $17.78 Typical High $17.78 | Facility | 51 · Multiple procedures | $11.48 | $17.78 | $17.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $18.62 Typical High $21.88 | Professional | 51 · Multiple procedures | $14.13 | $18.62 | $21.88 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 26th of 51
$31.62
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.