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 $91.20 Median $154.88 Typical High $2,041.74 | Facility | None | $91.20 | $154.88 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $245.47 | Professional | None | $91.20 | $154.88 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $131.83 Typical High $251.19 | Professional | None | $36.31 | $131.83 | $251.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $177.83 Median $239.88 Typical High $758.58 | Facility | None | $177.83 | $239.88 | $758.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $363.08 | Professional | None | $109.65 | $181.97 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $173.78 Typical High $630.96 | Facility | None | $112.20 | $173.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $302.00 | Professional | None | $125.89 | $181.97 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $1,548.82 | Facility | None | $154.88 | $239.88 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $204.17 | Professional | None | $147.91 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $275.42 | Professional | None | $91.20 | $144.54 | $275.42 |
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 $45.71 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $45.71 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $18.20 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $95.50 Typical High $117.49 | Professional | 54 · Surgery only | $69.18 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $23.44 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $15.49 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $77.62 Median $120.23 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $77.62 | $120.23 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $102.33 Typical High $120.23 | Professional | 51 · Multiple procedures | $74.13 | $102.33 | $120.23 |
Where North Carolina sits
The same service costs 3.2 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· 18th of 51
$182
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.