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 $114.82 Median $190.55 Typical High $7,943.28 | Facility | None | $114.82 | $190.55 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS North Carolina Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $346.74 | Professional | None | $154.88 | $251.19 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $2,187.76 | Facility | None | $478.63 | $602.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $295.12 | Professional | None | $107.15 | $120.23 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $1,621.81 Typical High $1,621.81 | Facility | None | $138.04 | $1,621.81 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $602.56 | Professional | None | $141.25 | $162.18 | $602.56 |
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 $100.00 Median $125.89 Typical High $281.84 | Professional | None | $100.00 | $125.89 | $281.84 |
6 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 $57.54 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $13.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $114.82 Typical High $302.00 | Professional | 51 · Multiple procedures | $75.86 | $114.82 | $302.00 |
Where North Carolina sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 5th of 51
$251
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.