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 $204.17 Median $1,047.13 Typical High $8,317.64 | Facility | None | $204.17 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | None | $204.17 | $204.17 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $8,912.51 | Facility | None | $3,548.13 | $5,754.40 | $8,912.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $707.95 | Professional | None | $288.40 | $446.68 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $8,317.64 | Facility | None | $602.56 | $5,128.61 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $562.34 | Professional | None | $269.15 | $309.03 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $416.87 Typical High $8,317.64 | Facility | None | $204.17 | $416.87 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $363.08 | Professional | None | $234.42 | $316.23 | $363.08 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $512.86 | Professional | None | $208.93 | $302.00 | $512.86 |
6 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 $102.33 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $158.49 Typical High $295.12 | Professional | 51 · Multiple procedures | $138.04 | $158.49 | $295.12 |
Where North Carolina sits
The same service costs 6.9 times more in Tennessee than in New York. 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
$407
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.