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 $630.96 Median $758.58 Typical High $7,943.28 | Facility | None | $630.96 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,230.27 | Professional | None | $630.96 | $758.58 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,862.09 | Professional | None | $676.08 | $977.24 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $2,238.72 | Facility | None | $645.65 | $1,862.09 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,698.24 | Professional | None | $707.95 | $831.76 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,174.90 | Professional | None | $812.83 | $812.83 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,137.96 | Facility | None | $588.84 | $977.24 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $977.24 | Professional | None | $741.31 | $933.25 | $977.24 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,659.59 | Professional | None | $562.34 | $741.31 | $1,659.59 |
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 $316.23 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $537.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $489.78 Typical High $645.65 | Professional | 51 · Multiple procedures | $371.54 | $489.78 | $645.65 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 23rd of 51
$912
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.