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 $100.00 Median $147.91 Typical High $5,248.07 | Facility | None | $100.00 | $147.91 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $165.96 | Professional | None | $100.00 | $147.91 | $165.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $426.58 | Facility | None | $107.15 | $169.82 | $426.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $416.87 | Professional | None | $138.04 | $234.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $524.81 | Facility | None | $134.90 | $213.80 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $323.59 | Professional | None | $107.15 | $147.91 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $288.40 | Facility | None | $125.89 | $194.98 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $245.47 | Professional | None | $141.25 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $323.59 | Professional | None | $95.50 | $147.91 | $323.59 |
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 $50.12 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.92 Typical High $33.11 | Professional | 53 · Discontinued | $19.95 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $74.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.00 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $95.50 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $69.18 | $95.50 | $114.82 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $63.10 Median $97.72 Typical High $141.25 | Facility | 51 · Multiple procedures | $63.10 | $97.72 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $89.13 Typical High $204.17 | Professional | 51 · Multiple procedures | $70.79 | $89.13 | $204.17 |
Where North Carolina sits
The same service costs 4.4 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· 15th of 51
$200
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.