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 $162.18 Median $275.42 Typical High $1,584.89 | Facility | None | $162.18 | $275.42 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $416.87 | Professional | None | $162.18 | $275.42 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $363.08 | Professional | None | $234.42 | $239.88 | $363.08 |
BCBS Setting Facility Modifier None Typical Low $162.18 Median $239.88 Typical High $323.59 | Facility | None | $162.18 | $239.88 | $323.59 |
BCBS Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $602.56 | Professional | None | $177.83 | $295.12 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $295.12 Typical High $478.63 | Facility | None | $56.23 | $295.12 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $512.86 | Professional | None | $177.83 | $257.04 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $354.81 | Professional | None | $234.42 | $234.42 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $467.74 | Facility | None | $169.82 | $239.88 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $380.19 | Professional | None | $234.42 | $323.59 | $380.19 |
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 $147.91 Median $234.42 Typical High $457.09 | Professional | None | $147.91 | $234.42 | $457.09 |
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 $81.28 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $114.82 | $151.36 | $194.98 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $112.20 Median $120.23 Typical High $234.42 | Facility | 51 · Multiple procedures | $112.20 | $120.23 | $234.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $158.49 Typical High $190.55 | Professional | 51 · Multiple procedures | $117.49 | $158.49 | $190.55 |
Where North Carolina sits
The same service costs 3.4 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· 21st of 51
$275
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.