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 $74.13 Median $162.18 Typical High $7,413.10 | Facility | None | $74.13 | $162.18 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $186.21 | Professional | None | $74.13 | $147.91 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $446.68 | Professional | None | $147.91 | $323.59 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $181.97 Typical High $354.81 | Professional | None | $89.13 | $181.97 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $177.83 | Facility | None | $74.13 | $74.13 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $371.54 | Professional | None | $154.88 | $208.93 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $338.84 | Professional | None | $77.62 | $162.18 | $338.84 |
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 $37.15 Median $60.26 Typical High $81.28 | Professional | 52 · Reduced service | $37.15 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $23.99 Typical High $32.36 | Professional | 53 · Discontinued | $14.79 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $91.20 Typical High $120.23 | Professional | 54 · Surgery only | $54.95 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $11.22 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.02 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.41 | $12.02 | $16.22 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $316.23 Typical High $707.95 | Professional | 50 · Both sides | $234.42 | $316.23 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $104.71 Typical High $234.42 | Professional | 51 · Multiple procedures | $77.62 | $104.71 | $234.42 |
Where North Carolina sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 3rd of 51
$263
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.