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 $37.15 Median $52.48 Typical High $2,630.27 | Facility | None | $37.15 | $52.48 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $85.11 | Professional | None | $37.15 | $52.48 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $75.86 | Professional | None | $39.81 | $53.70 | $75.86 |
BCBS North Carolina Setting Facility Modifier None Typical Low $28.18 Median $44.67 Typical High $112.20 | Facility | None | $28.18 | $44.67 | $112.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $144.54 | Professional | None | $52.48 | $79.43 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $52.48 Typical High $524.81 | Facility | None | $33.11 | $52.48 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $114.82 | Professional | None | $38.90 | $61.66 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | None | $87.10 | $87.10 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $52.48 Typical High $81.28 | Facility | None | $37.15 | $52.48 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $93.33 | Professional | None | $64.57 | $85.11 | $93.33 |
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 $34.67 Median $53.70 Typical High $109.65 | Professional | None | $34.67 | $53.70 | $109.65 |
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 $18.62 Median $25.12 Typical High $27.54 | Professional | 52 · Reduced service | $18.62 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.00 Typical High $10.96 | Professional | 53 · Discontinued | $7.41 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $37.15 Typical High $40.74 | Professional | 54 · Surgery only | $27.54 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.41 Typical High $8.13 | Professional | 55 · Aftercare only | $5.50 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.01 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.72 | $5.01 | $5.50 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $16.98 Median $26.30 Typical High $40.74 | Facility | 51 · Multiple procedures | $16.98 | $26.30 | $40.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $42.66 Typical High $72.44 | Professional | 51 · Multiple procedures | $32.36 | $42.66 | $72.44 |
Where North Carolina sits
The same service costs 4.2 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· 9th of 51
$79.43
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.