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 $16.98 Median $30.20 Typical High $5,248.07 | Facility | None | $16.98 | $30.20 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $30.20 | Professional | None | $16.98 | $25.70 | $30.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $35.48 Median $56.23 Typical High $141.25 | Facility | None | $35.48 | $56.23 | $141.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $19.50 Median $46.77 Typical High $112.20 | Professional | None | $19.50 | $46.77 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $870.96 | Facility | None | $50.12 | $50.12 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $45.71 Typical High $77.62 | Professional | None | $21.88 | $45.71 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | None | $85.11 | $85.11 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $19.95 Median $48.98 Typical High $66.07 | Facility | None | $19.95 | $48.98 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $58.88 | Professional | None | $28.18 | $46.77 | $58.88 |
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 $15.85 Median $33.11 Typical High $69.18 | Professional | None | $15.85 | $33.11 | $69.18 |
6 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 $12.88 Typical High $15.14 | Professional | 52 · Reduced service | $8.32 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.13 Typical High $6.03 | Professional | 53 · Discontinued | $3.39 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $19.05 Typical High $22.91 | Professional | 54 · Surgery only | $12.59 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.80 Typical High $4.57 | Professional | 55 · Aftercare only | $2.51 | $3.80 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.51 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.70 | $2.51 | $3.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $28.84 Typical High $31.62 | Professional | 51 · Multiple procedures | $14.13 | $28.84 | $31.62 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 11th of 51
$45.71
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.