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 $147.91 Median $549.54 Typical High $7,413.10 | Facility | None | $147.91 | $549.54 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $524.81 Typical High $660.69 | Professional | None | $147.91 | $524.81 | $660.69 |
BCBS North Carolina Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $1,445.44 | Professional | None | $302.00 | $562.34 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $489.78 Typical High $1,096.48 | Professional | None | $186.21 | $489.78 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $575.44 | Facility | None | $147.91 | $147.91 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $602.56 Typical High $1,148.15 | Professional | None | $204.17 | $602.56 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $154.88 Median $478.63 Typical High $1,047.13 | Professional | None | $154.88 | $478.63 | $1,047.13 |
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 $74.13 Median $173.78 Typical High $288.40 | Professional | 52 · Reduced service | $74.13 | $173.78 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $69.18 Typical High $114.82 | Professional | 53 · Discontinued | $30.20 | $69.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $263.03 Typical High $436.52 | Professional | 54 · Surgery only | $112.20 | $263.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $52.48 Typical High $87.10 | Professional | 55 · Aftercare only | $22.39 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $34.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $14.79 | $34.67 | $57.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $1,000.00 Typical High $2,137.96 | Professional | 50 · Both sides | $302.00 | $1,000.00 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $331.13 Typical High $724.44 | Professional | 51 · Multiple procedures | $102.33 | $331.13 | $724.44 |
Where North Carolina sits
The same service costs 3.5 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· 11th of 51
$562
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.