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 $446.68 Median $602.56 Typical High $8,511.38 | Facility | None | $446.68 | $602.56 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $831.76 | Professional | None | $446.68 | $602.56 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,737.80 | Professional | None | $676.08 | $1,258.93 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,445.44 | Professional | None | $562.34 | $676.08 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,202.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $977.24 | Professional | None | $562.34 | $758.58 | $977.24 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,412.54 | Professional | None | $467.74 | $676.08 | $1,412.54 |
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 $223.87 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $91.20 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $416.87 | $478.63 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $363.08 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $281.84 Median $380.19 Typical High $870.96 | Professional | 51 · Multiple procedures | $281.84 | $380.19 | $870.96 |
Where North Carolina sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 10th of 51
$1,023
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.