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 $707.95 Median $1,288.25 Typical High $8,317.64 | Facility | None | $707.95 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,174.90 | $1,737.80 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $2,137.96 | Professional | None | $831.76 | $1,174.90 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,479.11 | Professional | None | $645.65 | $758.58 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,096.48 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $2,818.38 | Facility | None | $602.56 | $977.24 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,202.26 | Professional | None | $831.76 | $954.99 | $1,202.26 |
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 $616.60 Median $758.58 Typical High $1,698.24 | Professional | None | $616.60 | $758.58 | $1,698.24 |
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 $354.81 Median $354.81 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $588.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $478.63 Typical High $870.96 | Professional | 51 · Multiple procedures | $416.87 | $478.63 | $870.96 |
Where North Carolina sits
The same service costs 6.6 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· 23rd of 51
$1,023
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.