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 $263.03 Median $331.13 Typical High $7,413.10 | Facility | None | $263.03 | $331.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $575.44 | Professional | None | $263.03 | $331.13 | $575.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $147.91 Median $218.78 Typical High $295.12 | Facility | None | $147.91 | $218.78 | $295.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $812.83 | Professional | None | $323.59 | $489.78 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $380.19 Typical High $676.08 | Facility | None | $245.47 | $380.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $741.31 | Professional | None | $354.81 | $407.38 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | None | $436.52 | $436.52 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $524.81 | Facility | None | $138.04 | $199.53 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $416.87 | Professional | None | $323.59 | $407.38 | $416.87 |
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 $245.47 Median $331.13 Typical High $724.44 | Professional | None | $245.47 | $331.13 | $724.44 |
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 $131.83 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $199.53 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $234.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $64.57 Median $100.00 Typical High $218.78 | Facility | 51 · Multiple procedures | $64.57 | $100.00 | $218.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $208.93 Typical High $275.42 | Professional | 51 · Multiple procedures | $162.18 | $208.93 | $275.42 |
Where North Carolina sits
The same service costs 4.7 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· 20th of 51
$398
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.