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 $102.33 Median $102.33 Typical High $134.90 | Facility | None | $102.33 | $102.33 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $147.91 | Professional | None | $102.33 | $134.90 | $147.91 |
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 $141.25 Median $245.47 Typical High $363.08 | Professional | None | $141.25 | $245.47 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $151.36 Typical High $234.42 | Facility | None | $56.23 | $151.36 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $316.23 | Professional | None | $120.23 | $147.91 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $323.59 | Professional | None | $218.78 | $218.78 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $213.80 | Facility | None | $97.72 | $144.54 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $229.09 | Professional | None | $144.54 | $165.96 | $229.09 |
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 $97.72 Median $138.04 Typical High $288.40 | Professional | None | $97.72 | $138.04 | $288.40 |
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 $51.29 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $51.29 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $27.54 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $14.45 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $138.04 Median $213.80 Typical High $323.59 | Facility | 50 · Both sides | $138.04 | $213.80 | $323.59 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $45.71 Median $72.44 Typical High $107.15 | Facility | 51 · Multiple procedures | $45.71 | $72.44 | $107.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $245.47 Typical High $512.86 | Professional | 50 · Both sides | $213.80 | $245.47 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $83.18 Typical High $169.82 | Professional | 51 · Multiple procedures | $72.44 | $83.18 | $169.82 |
Where North Carolina sits
The same service costs 4.0 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
$219
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.