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 $138.04 Median $257.04 Typical High $1,584.89 | Facility | None | $138.04 | $257.04 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $389.05 | Professional | None | $138.04 | $251.19 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $223.87 | Professional | None | $100.00 | $223.87 | $223.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $128.82 | Facility | None | $64.57 | $95.50 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $549.54 | Professional | None | $162.18 | $275.42 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $275.42 Typical High $457.09 | Facility | None | $56.23 | $275.42 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $457.09 | Professional | None | $162.18 | $218.78 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $309.03 | Professional | None | $213.80 | $213.80 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $165.96 Typical High $436.52 | Facility | None | $81.28 | $165.96 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $354.81 | Professional | None | $204.17 | $302.00 | $354.81 |
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 $131.83 Median $213.80 Typical High $416.87 | Professional | None | $131.83 | $213.80 | $416.87 |
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 $69.18 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $69.18 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $28.18 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $181.97 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $26.30 Median $40.74 Typical High $218.78 | Facility | 51 · Multiple procedures | $26.30 | $40.74 | $218.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $151.36 Typical High $177.83 | Professional | 51 · Multiple procedures | $102.33 | $151.36 | $177.83 |
Where North Carolina sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 24th of 51
$257
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.