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 $95.50 Median $128.82 Typical High $7,413.10 | Facility | None | $95.50 | $128.82 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $194.98 | Professional | None | $95.50 | $128.82 | $194.98 |
BCBS North Carolina Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $309.03 | Facility | None | $77.62 | $120.23 | $309.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $354.81 | Professional | None | $134.90 | $229.09 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $151.36 Typical High $229.09 | Facility | None | $56.23 | $151.36 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $302.00 | Professional | None | $112.20 | $144.54 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $309.03 | Professional | None | $213.80 | $213.80 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $213.80 | Facility | None | $95.50 | $141.25 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $218.78 | Professional | None | $125.89 | $158.49 | $218.78 |
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 $91.20 Median $131.83 Typical High $281.84 | Professional | None | $91.20 | $131.83 | $281.84 |
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 $47.86 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.70 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $14.45 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $12.88 | $13.80 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $138.04 Median $213.80 Typical High $316.23 | Facility | 50 · Both sides | $138.04 | $213.80 | $316.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $45.71 Median $70.79 Typical High $107.15 | Facility | 51 · Multiple procedures | $45.71 | $70.79 | $107.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $234.42 Typical High $489.78 | Professional | 50 · Both sides | $190.55 | $234.42 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $79.43 Typical High $162.18 | Professional | 51 · Multiple procedures | $63.10 | $79.43 | $162.18 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 9th of 51
$204
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.