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 $2.04 Median $6.46 Typical High $7,413.10 | Facility | None | $2.04 | $6.46 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $6.46 Typical High $11.48 | Professional | None | $2.04 | $6.46 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $5.13 Typical High $9.77 | Professional | None | $3.02 | $5.13 | $9.77 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.37 Median $6.31 Typical High $8.51 | Facility | None | $4.37 | $6.31 | $8.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4.57 Median $9.55 Typical High $15.85 | Professional | None | $4.57 | $9.55 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,995.26 | Facility | None | $50.12 | $50.12 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $10.00 Typical High $13.80 | Professional | None | $3.02 | $10.00 | $13.80 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $19.05 | Professional | None | $16.60 | $16.60 | $19.05 |
Medcost Setting Facility Modifier None Typical Low $4.47 Median $6.92 Typical High $53.70 | Facility | None | $4.47 | $6.92 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $6.61 Median $8.91 Typical High $18.20 | Professional | None | $6.61 | $8.91 | $18.20 |
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 $2.09 Median $5.37 Typical High $10.47 | Professional | None | $2.09 | $5.37 | $10.47 |
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 $1.02 Median $2.45 Typical High $3.24 | Professional | 52 · Reduced service | $1.02 | $2.45 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.98 Typical High $1.29 | Professional | 53 · Discontinued | $0.41 | $0.98 | $1.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.51 Median $3.72 Typical High $4.90 | Professional | 54 · Surgery only | $1.51 | $3.72 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.74 Typical High $0.98 | Professional | 55 · Aftercare only | $0.30 | $0.74 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.49 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.20 | $0.49 | $0.65 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $2.24 Median $3.47 Typical High $3.47 | Facility | 51 · Multiple procedures | $2.24 | $3.47 | $3.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.31 Median $4.57 Typical High $8.91 | Professional | 51 · Multiple procedures | $3.31 | $4.57 | $8.91 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 7th of 51
$7.94
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.