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 $117.49 Median $269.15 Typical High $5,495.41 | Facility | None | $117.49 | $269.15 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $302.00 | Professional | None | $117.49 | $245.47 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $331.13 | Facility | None | $165.96 | $245.47 | $331.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $645.65 | Professional | None | $177.83 | $302.00 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $316.23 Typical High $512.86 | Facility | None | $56.23 | $316.23 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $489.78 | Professional | None | $131.83 | $208.93 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $501.19 | Facility | None | $141.25 | $218.78 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $436.52 | Professional | None | $194.98 | $269.15 | $436.52 |
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 $117.49 Median $229.09 Typical High $467.74 | Professional | None | $117.49 | $229.09 | $467.74 |
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 $58.88 Median $91.20 Typical High $134.90 | Professional | 52 · Reduced service | $58.88 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $53.70 | Professional | 53 · Discontinued | $23.44 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $138.04 Typical High $204.17 | Professional | 54 · Surgery only | $89.13 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $27.54 Typical High $40.74 | Professional | 55 · Aftercare only | $17.78 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $128.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $83.18 | $128.82 | $190.55 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $109.65 Median $109.65 Typical High $251.19 | Facility | 51 · Multiple procedures | $109.65 | $109.65 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $134.90 Typical High $354.81 | Professional | 51 · Multiple procedures | $97.72 | $134.90 | $354.81 |
Where North Carolina sits
The same service costs 3.9 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· 14th of 51
$282
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.