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 $144.54 Median $213.80 Typical High $7,244.36 | Facility | None | $144.54 | $213.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $309.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $123.03 Median $190.55 Typical High $489.78 | Facility | None | $123.03 | $190.55 | $489.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $537.03 | Professional | None | $194.98 | $316.23 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $562.34 | Facility | None | $186.21 | $295.12 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $436.52 | Professional | None | $158.49 | $213.80 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $512.86 | Professional | None | $302.00 | $302.00 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $354.81 | Facility | None | $144.54 | $229.09 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $467.74 | Professional | None | $204.17 | $251.19 | $467.74 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $426.58 | Professional | None | $131.83 | $204.17 | $426.58 |
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 $72.44 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $72.44 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $39.81 Typical High $42.66 | Professional | 53 · Discontinued | $28.84 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $158.49 | Professional | 54 · Surgery only | $107.15 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.95 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.45 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $147.91 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $72.44 Median $114.82 Typical High $177.83 | Facility | 51 · Multiple procedures | $72.44 | $114.82 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $144.54 Typical High $257.04 | Professional | 51 · Multiple procedures | $102.33 | $144.54 | $257.04 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 9th of 51
$309
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.