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 $27.54 Median $27.54 Typical High $40.74 | Facility | None | $27.54 | $27.54 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $40.74 Typical High $43.65 | Professional | None | $27.54 | $40.74 | $43.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $33.88 Median $52.48 Typical High $134.90 | Facility | None | $33.88 | $52.48 | $134.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $128.82 | Professional | None | $42.66 | $70.79 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $79.43 | Facility | None | $28.18 | $43.65 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $89.13 | Professional | None | $38.02 | $56.23 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | None | $83.18 | $83.18 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $39.81 Typical High $63.10 | Facility | None | $27.54 | $39.81 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $72.44 | Professional | None | $39.81 | $58.88 | $72.44 |
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 $26.92 Median $42.66 Typical High $89.13 | Professional | None | $26.92 | $42.66 | $89.13 |
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 $13.80 Median $20.42 Typical High $21.38 | Professional | 52 · Reduced service | $13.80 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $5.50 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $4.17 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $4.07 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.75 | $4.07 | $4.37 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $38.90 Median $60.26 Typical High $91.20 | Facility | 50 · Both sides | $38.90 | $60.26 | $91.20 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $12.88 Median $19.95 Typical High $30.20 | Facility | 51 · Multiple procedures | $12.88 | $19.95 | $30.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $93.33 Typical High $158.49 | Professional | 50 · Both sides | $60.26 | $93.33 | $158.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.95 Median $30.90 Typical High $53.70 | Professional | 51 · Multiple procedures | $19.95 | $30.90 | $53.70 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 12th of 51
$58.88
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.