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 $114.82 Median $263.03 Typical High $7,585.78 | Facility | None | $114.82 | $263.03 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $257.04 Typical High $323.59 | Professional | None | $114.82 | $257.04 | $323.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,290.87 | Facility | None | $1,122.02 | $1,659.59 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $190.55 Median $398.11 Typical High $676.08 | Professional | None | $190.55 | $398.11 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $1,819.70 | Facility | None | $602.56 | $1,380.38 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $512.86 | Professional | None | $147.91 | $245.47 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $831.76 Typical High $1,174.90 | Facility | None | $263.03 | $831.76 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $436.52 | Professional | None | $213.80 | $275.42 | $436.52 |
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 $117.49 Median $239.88 Typical High $489.78 | Professional | None | $117.49 | $239.88 | $489.78 |
7 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 $57.54 Median $93.33 Typical High $144.54 | Professional | 52 · Reduced service | $57.54 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.02 Typical High $58.88 | Professional | 53 · Discontinued | $22.91 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $141.25 Typical High $218.78 | Professional | 54 · Surgery only | $87.10 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.18 Typical High $43.65 | Professional | 55 · Aftercare only | $17.38 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.05 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.48 | $19.05 | $29.51 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $446.68 Typical High $812.83 | Facility | 51 · Multiple procedures | $263.03 | $446.68 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $138.04 Typical High $371.54 | Professional | 51 · Multiple procedures | $107.15 | $138.04 | $371.54 |
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· 18th of 51
$339
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.