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 $45.71 Median $1,000.00 Typical High $7,943.28 | Facility | None | $45.71 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $190.55 | Professional | None | $45.71 | $45.71 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $35.48 Median $54.95 Typical High $141.25 | Facility | None | $35.48 | $54.95 | $141.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $117.49 | Professional | None | $45.71 | $74.13 | $117.49 |
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 $52.48 Median $66.07 Typical High $123.03 | Professional | None | $52.48 | $66.07 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | None | $151.36 | $151.36 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $47.86 Typical High $74.13 | Facility | None | $30.20 | $47.86 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $107.15 | Professional | None | $43.65 | $60.26 | $107.15 |
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 $38.90 Median $46.77 Typical High $107.15 | Professional | None | $38.90 | $46.77 | $107.15 |
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 $22.91 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 54 · Surgery only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 58 · Staged procedure | $57.54 | $57.54 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $30.20 Typical High $53.70 | Professional | 51 · Multiple procedures | $21.38 | $30.20 | $53.70 |
Where North Carolina sits
The same service costs 13.8 times more in Oklahoma than in New York. 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
$72.44
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.