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 $89.13 Median $117.49 Typical High $5,248.07 | Facility | None | $89.13 | $117.49 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $117.49 | Professional | None | $89.13 | $109.65 | $117.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $138.04 | Facility | None | $70.79 | $104.71 | $138.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $302.00 | Professional | None | $95.50 | $125.89 | $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 $102.33 Median $125.89 Typical High $269.15 | Professional | None | $102.33 | $125.89 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | None | $112.20 | $112.20 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $141.25 | Facility | None | $66.07 | $102.33 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | None | $117.49 | $162.18 | $162.18 |
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 $83.18 Median $117.49 Typical High $251.19 | Professional | None | $83.18 | $117.49 | $251.19 |
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 $44.67 Median $52.48 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $17.78 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $79.43 Typical High $89.13 | Professional | 54 · Surgery only | $66.07 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $74.13 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $61.66 | $74.13 | $83.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $79.43 Typical High $102.33 | Professional | 51 · Multiple procedures | $58.88 | $79.43 | $102.33 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in New York. 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· 32nd of 51
$123
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.