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 $39.81 Median $63.10 Typical High $5,495.41 | Facility | None | $39.81 | $63.10 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $97.72 | Professional | None | $39.81 | $63.10 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $102.33 | Professional | None | $41.69 | $83.18 | $102.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $30.90 Median $45.71 Typical High $61.66 | Facility | None | $30.90 | $45.71 | $61.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $158.49 | Professional | None | $58.88 | $91.20 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $524.81 | Facility | None | $50.12 | $77.62 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $125.89 | Professional | None | $47.86 | $64.57 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $144.54 | Professional | None | $93.33 | $93.33 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $58.88 Typical High $89.13 | Facility | None | $39.81 | $58.88 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $100.00 | Professional | None | $67.61 | $81.28 | $100.00 |
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 $38.90 Median $58.88 Typical High $123.03 | Professional | None | $38.90 | $58.88 | $123.03 |
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 $19.95 Median $29.51 Typical High $30.90 | Professional | 52 · Reduced service | $19.95 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $11.75 Typical High $12.59 | Professional | 53 · Discontinued | $8.13 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $44.67 Typical High $46.77 | Professional | 54 · Surgery only | $30.20 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.91 Typical High $9.33 | Professional | 55 · Aftercare only | $6.03 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.89 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.98 | $5.89 | $6.31 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $19.05 Median $29.51 Typical High $44.67 | Facility | 51 · Multiple procedures | $19.05 | $29.51 | $44.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $44.67 Typical High $77.62 | Professional | 51 · Multiple procedures | $33.88 | $44.67 | $77.62 |
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· 10th of 51
$87.10
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.