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 $40.74 Median $77.62 Typical High $112.20 | Facility | None | $40.74 | $77.62 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $77.62 Typical High $117.49 | Professional | None | $40.74 | $77.62 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $151.36 | Professional | None | $39.81 | $60.26 | $151.36 |
BCBS North Carolina Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $100.00 | Facility | None | $50.12 | $74.13 | $100.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $229.09 | Professional | None | $75.86 | $134.90 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $109.65 Typical High $158.49 | Facility | None | $56.23 | $109.65 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $177.83 | Professional | None | $63.10 | $93.33 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | None | $134.90 | $134.90 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $91.20 Typical High $138.04 | Facility | None | $57.54 | $91.20 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $138.04 | Professional | None | $77.62 | $107.15 | $138.04 |
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 $40.74 Median $79.43 Typical High $151.36 | Professional | None | $40.74 | $79.43 | $151.36 |
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 $20.42 Median $36.31 Typical High $41.69 | Professional | 52 · Reduced service | $20.42 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $14.45 Typical High $16.60 | Professional | 53 · Discontinued | $8.13 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.72 Typical High $12.30 | Professional | 55 · Aftercare only | $6.17 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.24 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.07 | $7.24 | $8.32 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $87.10 Median $134.90 Typical High $204.17 | Facility | 50 · Both sides | $87.10 | $134.90 | $204.17 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $28.84 Median $45.71 Typical High $69.18 | Facility | 51 · Multiple procedures | $28.84 | $45.71 | $69.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $186.21 Typical High $302.00 | Professional | 50 · Both sides | $117.49 | $186.21 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $61.66 Typical High $100.00 | Professional | 51 · Multiple procedures | $38.90 | $61.66 | $100.00 |
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· 5th of 51
$123
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.