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 $38.90 Median $63.10 Typical High $93.33 | Facility | None | $38.90 | $63.10 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $97.72 | Professional | None | $38.90 | $63.10 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $117.49 | Professional | None | $53.70 | $85.11 | $117.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $43.65 Median $67.61 Typical High $173.78 | Facility | None | $43.65 | $67.61 | $173.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $169.82 | Professional | None | $57.54 | $97.72 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $131.83 | Professional | None | $44.67 | $70.79 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | None | $100.00 | $100.00 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $81.28 Typical High $100.00 | Facility | None | $52.48 | $81.28 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $109.65 | Professional | None | $61.66 | $85.11 | $109.65 |
Oscar Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $37.15 Median $61.66 Typical High $128.82 | Professional | None | $37.15 | $61.66 | $128.82 |
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 $19.05 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $19.05 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $11.75 Typical High $13.18 | Professional | 53 · Discontinued | $7.76 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.91 Typical High $9.77 | Professional | 55 · Aftercare only | $5.75 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.89 | $5.89 | $6.46 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $77.62 Median $123.03 Typical High $123.03 | Facility | 50 · Both sides | $77.62 | $123.03 | $123.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $26.30 Median $40.74 Typical High $40.74 | Facility | 51 · Multiple procedures | $26.30 | $40.74 | $40.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $131.83 Typical High $239.88 | Professional | 50 · Both sides | $93.33 | $131.83 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $43.65 Typical High $81.28 | Professional | 51 · Multiple procedures | $30.90 | $43.65 | $81.28 |
Where North Carolina sits
The same service costs 4.0 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
$95.50
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.