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 $64.57 Median $64.57 Typical High $91.20 | Facility | None | $64.57 | $64.57 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $128.82 | Professional | None | $64.57 | $91.20 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $234.42 | Facility | None | $58.88 | $91.20 | $234.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $251.19 | Professional | None | $89.13 | $147.91 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $120.23 Typical High $177.83 | Facility | None | $56.23 | $120.23 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $204.17 | Professional | None | $69.18 | $97.72 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $218.78 | Professional | None | $141.25 | $141.25 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $162.18 | Facility | None | $61.66 | $91.20 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $154.88 | Professional | None | $91.20 | $109.65 | $154.88 |
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 $60.26 Median $91.20 Typical High $194.98 | Professional | None | $60.26 | $91.20 | $194.98 |
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 $32.36 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $32.36 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $12.88 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.46 | $9.12 | $9.77 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $87.10 Median $134.90 Typical High $245.47 | Facility | 50 · Both sides | $87.10 | $134.90 | $245.47 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $28.84 Median $45.71 Typical High $81.28 | Facility | 51 · Multiple procedures | $28.84 | $45.71 | $81.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $162.18 Typical High $346.74 | Professional | 50 · Both sides | $134.90 | $162.18 | $346.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $54.95 Typical High $117.49 | Professional | 51 · Multiple procedures | $44.67 | $54.95 | $117.49 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 10th of 51
$138
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.