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 $112.20 Median $112.20 Typical High $141.25 | Facility | None | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $213.80 | Professional | None | $112.20 | $141.25 | $213.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $61.66 Median $93.33 Typical High $245.47 | Facility | None | $61.66 | $93.33 | $245.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $407.38 | Professional | None | $151.36 | $239.88 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $117.49 Typical High $173.78 | Facility | None | $56.23 | $117.49 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $323.59 | Professional | None | $141.25 | $165.96 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | None | $245.47 | $245.47 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $229.09 | Facility | None | $61.66 | $91.20 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $239.88 | Professional | None | $138.04 | $181.97 | $239.88 |
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 $104.71 Median $151.36 Typical High $309.03 | Professional | None | $104.71 | $151.36 | $309.03 |
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 $56.23 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $56.23 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $14.45 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $87.10 Median $134.90 Typical High $269.15 | Facility | 50 · Both sides | $87.10 | $134.90 | $269.15 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $28.84 Median $45.71 Typical High $91.20 | Facility | 51 · Multiple procedures | $28.84 | $45.71 | $91.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $269.15 Typical High $524.81 | Professional | 50 · Both sides | $204.17 | $269.15 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $91.20 Typical High $173.78 | Professional | 51 · Multiple procedures | $69.18 | $91.20 | $173.78 |
Where North Carolina sits
The same service costs 4.3 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· 13th of 51
$195
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.