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 $218.78 Median $251.19 Typical High $7,413.10 | Facility | None | $218.78 | $251.19 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $426.58 | Professional | None | $218.78 | $251.19 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Facility | None | $79.43 | $117.49 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $741.31 | Professional | None | $302.00 | $426.58 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $204.17 Typical High $331.13 | Facility | None | $56.23 | $204.17 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $588.84 | Professional | None | $275.42 | $288.40 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $588.84 | Professional | None | $416.87 | $416.87 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $398.11 | Facility | None | $87.10 | $158.49 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $537.03 | Professional | None | $281.84 | $309.03 | $537.03 |
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 $199.53 Median $275.42 Typical High $575.44 | Professional | None | $199.53 | $275.42 | $575.44 |
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 $109.65 Median $125.89 Typical High $131.83 | Professional | 52 · Reduced service | $109.65 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 53 · Discontinued | $44.67 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 54 · Surgery only | $165.96 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $37.15 Typical High $39.81 | Professional | 55 · Aftercare only | $33.11 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $186.21 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $43.65 Typical High $162.18 | Facility | 51 · Multiple procedures | $40.74 | $43.65 | $162.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $154.88 Typical High $316.23 | Professional | 51 · Multiple procedures | $141.25 | $154.88 | $316.23 |
Where North Carolina sits
The same service costs 5.1 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· 14th of 51
$372
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.