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 $275.42 Median $309.03 Typical High $7,943.28 | Facility | None | $275.42 | $309.03 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $501.19 | Professional | None | $275.42 | $309.03 | $501.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,862.09 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $912.01 | Professional | None | $309.03 | $562.34 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $2,089.30 | Facility | None | $645.65 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $831.76 | Professional | None | $338.84 | $363.08 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | None | $512.86 | $512.86 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $1,659.59 | Facility | None | $371.54 | $977.24 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $645.65 | Professional | None | $316.23 | $398.11 | $645.65 |
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 $251.19 Median $338.84 Typical High $724.44 | Professional | None | $251.19 | $338.84 | $724.44 |
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 $134.90 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $229.09 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $933.25 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $199.53 Typical High $398.11 | Professional | 51 · Multiple procedures | $158.49 | $199.53 | $398.11 |
Where North Carolina sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 12th of 51
$501
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.