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 $660.69 Median $1,047.13 Typical High $8,317.64 | Facility | None | $660.69 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,479.11 | Professional | None | $660.69 | $660.69 | $1,479.11 |
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 $1,445.44 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,949.84 | $1,949.84 |
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 $134.90 Median $257.04 Typical High $891.25 | Professional | None | $134.90 | $257.04 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $3,162.28 | Facility | None | $588.84 | $933.25 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $1,258.93 Typical High $3,019.95 | Professional | None | $302.00 | $1,258.93 | $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 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,445.44 Typical High $5,754.40 | Facility | 50 · Both sides | $891.25 | $1,445.44 | $5,754.40 |
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 67.6 times more in Oklahoma 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· 17th of 51
$1,862
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.