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 $64.57 Median $109.65 Typical High $5,248.07 | Facility | None | $64.57 | $109.65 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $169.82 | Professional | None | $64.57 | $109.65 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $158.49 | Professional | None | $79.43 | $95.50 | $158.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $190.55 | Facility | None | $47.86 | $74.13 | $190.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $251.19 | Professional | None | $61.66 | $112.20 | $251.19 |
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 $60.26 Median $100.00 Typical High $208.93 | Professional | None | $60.26 | $100.00 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | None | $123.03 | $123.03 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $223.87 | Facility | None | $43.65 | $69.18 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $154.88 | Professional | None | $89.13 | $112.20 | $154.88 |
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 $56.23 Median $93.33 Typical High $186.21 | Professional | None | $56.23 | $93.33 | $186.21 |
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 $32.36 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $32.36 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $12.88 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $66.07 Typical High $83.18 | Professional | 54 · Surgery only | $47.86 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $9.55 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.46 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $61.66 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $44.67 | $61.66 | $77.62 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $21.88 Median $33.88 Typical High $43.65 | Facility | 51 · Multiple procedures | $21.88 | $33.88 | $43.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $56.23 Typical High $89.13 | Professional | 51 · Multiple procedures | $44.67 | $56.23 | $89.13 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 25th of 51
$110
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.