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 $70.79 Median $194.98 Typical High $4,265.80 | Facility | None | $70.79 | $194.98 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $309.03 | Professional | None | $70.79 | $169.82 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS North Carolina Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $512.86 | Professional | None | $141.25 | $316.23 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $204.17 Typical High $407.38 | Professional | None | $89.13 | $204.17 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $208.93 | Facility | None | $70.79 | $70.79 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $724.44 | Professional | None | $186.21 | $251.19 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $74.13 Median $177.83 Typical High $398.11 | Professional | None | $74.13 | $177.83 | $398.11 |
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 $35.48 Median $67.61 Typical High $97.72 | Professional | 52 · Reduced service | $35.48 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $14.45 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $102.33 Typical High $147.91 | Professional | 54 · Surgery only | $53.70 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $20.42 Typical High $29.51 | Professional | 55 · Aftercare only | $10.72 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $7.08 | $13.80 | $19.50 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $645.65 Typical High $1,096.48 | Professional | 50 · Both sides | $275.42 | $645.65 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $93.33 Median $213.80 Typical High $363.08 | Professional | 51 · Multiple procedures | $93.33 | $213.80 | $363.08 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 3rd of 51
$302
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.