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 $8.71 Median $28.84 Typical High $32.36 | Facility | None | $8.71 | $28.84 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $22.39 Typical High $41.69 | Professional | None | $8.71 | $22.39 | $41.69 |
BCBS Setting Professional Modifier None Typical Low $15.49 Median $35.48 Typical High $66.07 | Professional | None | $15.49 | $35.48 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,995.26 Typical High $2,290.87 | Facility | None | $870.96 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $31.62 Typical High $66.07 | Professional | None | $10.47 | $31.62 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $9.12 Median $28.84 Typical High $54.95 | Facility | None | $9.12 | $28.84 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $60.26 | Professional | None | $28.18 | $36.31 | $60.26 |
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 $9.77 Median $25.12 Typical High $69.18 | Professional | None | $9.77 | $25.12 | $69.18 |
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 $4.37 Median $7.59 Typical High $15.14 | Professional | 52 · Reduced service | $4.37 | $7.59 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $3.02 Typical High $6.03 | Professional | 53 · Discontinued | $1.74 | $3.02 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.61 Median $11.22 Typical High $22.39 | Professional | 54 · Surgery only | $6.61 | $11.22 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $2.24 Typical High $4.47 | Professional | 55 · Aftercare only | $1.32 | $2.24 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.51 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.87 | $1.51 | $3.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $18.20 Typical High $38.90 | Professional | 51 · Multiple procedures | $14.13 | $18.20 | $38.90 |
Where North Carolina sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 14th of 51
$33.88
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.