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 $251.19 Median $363.08 Typical High $7,413.10 | Facility | None | $251.19 | $363.08 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $416.87 | Professional | None | $251.19 | $363.08 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $1,023.29 | Facility | None | $257.04 | $407.38 | $1,023.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Professional | None | $371.54 | $724.44 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $851.14 | Facility | None | $309.03 | $478.63 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $812.83 | Professional | None | $309.03 | $389.05 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $891.25 | Professional | None | $549.54 | $549.54 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $724.44 | Facility | None | $309.03 | $478.63 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $602.56 | Professional | None | $316.23 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $794.33 | Professional | None | $245.47 | $380.19 | $794.33 |
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 $125.89 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $125.89 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $50.12 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $190.55 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.12 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $177.83 | $245.47 | $269.15 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $239.88 Typical High $363.08 | Facility | 51 · Multiple procedures | $154.88 | $239.88 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $229.09 Typical High $436.52 | Professional | 51 · Multiple procedures | $158.49 | $229.09 | $436.52 |
Where North Carolina sits
The same service costs 5.2 times more in Alaska than in Texas. 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
$575
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.