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 $16.60 Median $30.20 Typical High $5,495.41 | Facility | None | $16.60 | $30.20 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $69.18 | Professional | None | $16.60 | $30.20 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $46.77 Typical High $75.86 | Professional | None | $18.62 | $46.77 | $75.86 |
BCBS Setting Facility Modifier None Typical Low $23.44 Median $33.88 Typical High $45.71 | Facility | None | $23.44 | $33.88 | $45.71 |
BCBS Setting Professional Modifier None Typical Low $29.51 Median $54.95 Typical High $104.71 | Professional | None | $29.51 | $54.95 | $104.71 |
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 $33.88 Median $44.67 Typical High $79.43 | Professional | None | $33.88 | $44.67 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | None | $66.07 | $66.07 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $42.66 Typical High $47.86 | Facility | None | $27.54 | $42.66 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $56.23 | Professional | None | $41.69 | $52.48 | $56.23 |
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 $23.44 Median $38.02 Typical High $69.18 | Professional | None | $23.44 | $38.02 | $69.18 |
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 $8.32 Median $14.45 Typical High $15.14 | Professional | 52 · Reduced service | $8.32 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.75 Typical High $6.03 | Professional | 53 · Discontinued | $3.31 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $21.88 Typical High $22.39 | Professional | 54 · Surgery only | $12.30 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.37 Typical High $4.47 | Professional | 55 · Aftercare only | $2.51 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.88 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.66 | $2.88 | $3.02 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $13.80 Median $21.38 Typical High $21.38 | Facility | 51 · Multiple procedures | $13.80 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.89 Median $26.30 Typical High $33.88 | Professional | 51 · Multiple procedures | $20.89 | $26.30 | $33.88 |
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· 27th of 51
$44.67
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.