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 $85.11 Median $100.00 Typical High $141.25 | Facility | None | $85.11 | $100.00 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $134.90 | Professional | None | $85.11 | $117.49 | $134.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $141.25 | Facility | None | $70.79 | $104.71 | $141.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $323.59 | Professional | None | $117.49 | $190.55 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $147.91 Typical High $223.87 | Facility | None | $56.23 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $263.03 | Professional | None | $97.72 | $128.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | None | $186.21 | $186.21 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $199.53 | Facility | None | $87.10 | $134.90 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $199.53 | Professional | None | $117.49 | $141.25 | $199.53 |
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 $81.28 Median $117.49 Typical High $251.19 | Professional | None | $81.28 | $117.49 | $251.19 |
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 $41.69 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $16.98 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.38 Typical High $18.62 | Professional | 55 · Aftercare only | $12.59 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.51 | $11.75 | $12.30 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $131.83 Median $204.17 Typical High $302.00 | Facility | 50 · Both sides | $131.83 | $204.17 | $302.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $43.65 Median $67.61 Typical High $100.00 | Facility | 51 · Multiple procedures | $43.65 | $67.61 | $100.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $213.80 Typical High $446.68 | Professional | 50 · Both sides | $173.78 | $213.80 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $70.79 Typical High $151.36 | Professional | 51 · Multiple procedures | $57.54 | $70.79 | $151.36 |
Where North Carolina sits
The same service costs 3.6 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
$182
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.