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 $194.98 Typical High $7,585.78 | Facility | None | $114.82 | $194.98 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $302.00 | Professional | None | $114.82 | $194.98 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $354.81 | Professional | None | $109.65 | $173.78 | $354.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $251.19 | Facility | None | $125.89 | $186.21 | $251.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $562.34 | Professional | None | $208.93 | $389.05 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $524.81 | Facility | None | $147.91 | $239.88 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $398.11 | Professional | None | $162.18 | $257.04 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $295.12 | Facility | None | $144.54 | $223.87 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $346.74 | Professional | None | $223.87 | $295.12 | $346.74 |
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 $123.03 Median $208.93 Typical High $446.68 | Professional | None | $123.03 | $208.93 | $446.68 |
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 $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $57.54 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $40.74 | Professional | 53 · Discontinued | $22.91 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $87.10 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $20.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $72.44 Median $112.20 Typical High $147.91 | Facility | 51 · Multiple procedures | $72.44 | $112.20 | $147.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $147.91 Typical High $269.15 | Professional | 51 · Multiple procedures | $131.83 | $147.91 | $269.15 |
Where North Carolina sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 9th of 51
$295
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.