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 $107.15 Median $173.78 Typical High $7,413.10 | Facility | None | $107.15 | $173.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $275.42 | Professional | None | $107.15 | $173.78 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $288.40 | Professional | None | $125.89 | $223.87 | $288.40 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $371.54 | Professional | None | $114.82 | $169.82 | $371.54 |
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 $117.49 Median $151.36 Typical High $346.74 | Professional | None | $117.49 | $151.36 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | None | $213.80 | $213.80 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $194.98 | Facility | None | $66.07 | $102.33 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $245.47 | Professional | None | $144.54 | $204.17 | $245.47 |
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 $100.00 Median $151.36 Typical High $309.03 | Professional | None | $100.00 | $151.36 | $309.03 |
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 $53.70 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $21.38 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $109.65 Typical High $128.82 | Professional | 54 · Surgery only | $79.43 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $15.85 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $102.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $74.13 | $102.33 | $120.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $104.71 Typical High $138.04 | Professional | 51 · Multiple procedures | $72.44 | $104.71 | $138.04 |
Where North Carolina sits
The same service costs 3.4 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· 30th of 51
$170
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.