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 $83.18 Median $134.90 Typical High $7,413.10 | Facility | None | $83.18 | $134.90 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $218.78 | Professional | None | $83.18 | $134.90 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $158.49 | Facility | None | $81.28 | $120.23 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $302.00 | Professional | None | $89.13 | $134.90 | $302.00 |
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 $89.13 Median $123.03 Typical High $275.42 | Professional | None | $89.13 | $123.03 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | None | $169.82 | $169.82 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $154.88 | Facility | None | $66.07 | $102.33 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $165.96 | Professional | None | $114.82 | $165.96 | $165.96 |
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 $75.86 Median $120.23 Typical High $245.47 | Professional | None | $75.86 | $120.23 | $245.47 |
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 $41.69 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $41.69 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $16.60 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $61.66 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.32 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $81.28 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $57.54 | $81.28 | $95.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $83.18 Typical High $91.20 | Professional | 51 · Multiple procedures | $57.54 | $83.18 | $91.20 |
Where North Carolina sits
The same service costs 3.5 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· 31st of 51
$132
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.