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 $77.62 Median $1,000.00 Typical High $7,943.28 | Facility | None | $77.62 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | None | $77.62 | $77.62 | $100.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $245.47 | Professional | None | $120.23 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $194.98 | Professional | None | $104.71 | $120.23 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $416.87 | Facility | None | $77.62 | $125.89 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $181.97 | Professional | None | $93.33 | $128.82 | $181.97 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $213.80 | Professional | None | $79.43 | $112.20 | $213.80 |
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 $38.90 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $38.90 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $15.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 54 · Surgery only | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $74.13 Typical High $114.82 | Professional | 51 · Multiple procedures | $52.48 | $74.13 | $114.82 |
Where North Carolina sits
The same service costs 6.5 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· 7th of 51
$182
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.