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 $371.54 Median $1,288.25 Typical High $8,317.64 | Facility | None | $371.54 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $724.44 | Professional | None | $371.54 | $371.54 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,819.70 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,238.72 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $3,890.45 | Facility | None | $645.65 | $2,630.27 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $501.19 | Professional | None | $223.87 | $257.04 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $3,162.28 | Facility | None | $575.44 | $933.25 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,905.46 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,905.46 |
Where North Carolina sits
The same service costs 64.6 times more in Wisconsin than in Montana. 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· 12th of 51
$2,239
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.