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 $43.65 Median $43.65 Typical High $61.66 | Facility | None | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $66.07 | Professional | None | $43.65 | $60.26 | $66.07 |
BCBS North Carolina Setting Facility Modifier None Typical Low $33.88 Median $50.12 Typical High $67.61 | Facility | None | $33.88 | $50.12 | $67.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $165.96 | Professional | None | $60.26 | $95.50 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $64.57 Typical High $120.23 | Facility | None | $45.71 | $64.57 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $134.90 | Professional | None | $50.12 | $72.44 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $89.13 | Facility | None | $43.65 | $63.10 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $107.15 | Professional | None | $60.26 | $77.62 | $107.15 |
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 $40.74 Median $61.66 Typical High $128.82 | Professional | None | $40.74 | $61.66 | $128.82 |
6 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 $21.38 Median $30.20 Typical High $32.36 | Professional | 52 · Reduced service | $21.38 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.02 Typical High $12.88 | Professional | 53 · Discontinued | $8.71 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.91 Typical High $9.55 | Professional | 55 · Aftercare only | $6.46 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.03 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.37 | $6.03 | $6.46 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $20.42 Median $31.62 Typical High $44.67 | Facility | 51 · Multiple procedures | $20.42 | $31.62 | $44.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $38.90 Typical High $77.62 | Professional | 51 · Multiple procedures | $30.20 | $38.90 | $77.62 |
Where North Carolina sits
The same service costs 3.5 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· 17th of 51
$77.62
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.