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 $204.17 Median $380.19 Typical High $5,248.07 | Facility | None | $204.17 | $380.19 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $380.19 | Professional | None | $204.17 | $331.13 | $380.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $93.33 | Facility | None | $47.86 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $104.71 Median $363.08 Typical High $1,000.00 | Professional | None | $104.71 | $363.08 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $758.58 | Professional | None | $229.09 | $380.19 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $426.58 | Facility | None | $43.65 | $69.18 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $501.19 Typical High $512.86 | Professional | None | $213.80 | $501.19 | $512.86 |
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 $199.53 Median $354.81 Typical High $676.08 | Professional | None | $199.53 | $354.81 | $676.08 |
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 $102.33 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $102.33 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $40.74 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $154.88 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $30.90 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $144.54 | $229.09 | $263.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $21.88 Median $33.88 Typical High $33.88 | Facility | 51 · Multiple procedures | $21.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $257.04 Typical High $338.84 | Professional | 51 · Multiple procedures | $107.15 | $257.04 | $338.84 |
Where North Carolina sits
The same service costs 4.6 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· 32nd of 51
$355
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.