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 $33.11 Median $47.86 Typical High $53.70 | Facility | None | $33.11 | $47.86 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $56.23 | Professional | None | $33.11 | $48.98 | $56.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $29.51 Median $43.65 Typical High $57.54 | Facility | None | $29.51 | $43.65 | $57.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $138.04 | Professional | None | $44.67 | $72.44 | $138.04 |
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 $34.67 Median $56.23 Typical High $107.15 | Professional | None | $34.67 | $56.23 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | None | $79.43 | $79.43 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $33.11 Median $51.29 Typical High $61.66 | Facility | None | $33.11 | $51.29 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $89.13 | Professional | None | $50.12 | $60.26 | $89.13 |
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 $31.62 Median $50.12 Typical High $104.71 | Professional | None | $31.62 | $50.12 | $104.71 |
6 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 $16.60 Median $23.99 Typical High $25.70 | Professional | 52 · Reduced service | $16.60 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $9.55 Typical High $10.23 | Professional | 53 · Discontinued | $6.76 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.24 Typical High $7.76 | Professional | 55 · Aftercare only | $5.01 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.79 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.39 | $4.79 | $5.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $91.20 Typical High $199.53 | Professional | 50 · Both sides | $75.86 | $91.20 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $30.20 Typical High $66.07 | Professional | 51 · Multiple procedures | $25.12 | $30.20 | $66.07 |
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· 14th of 51
$64.57
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.