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 $134.90 Median $602.56 Typical High $7,585.78 | Facility | None | $134.90 | $602.56 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $602.56 Typical High $794.33 | Professional | None | $134.90 | $602.56 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $1,737.80 | Professional | None | $281.84 | $426.58 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $478.63 Typical High $1,258.93 | Professional | None | $177.83 | $478.63 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $630.96 | Facility | None | $134.90 | $134.90 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $676.08 Typical High $1,258.93 | Professional | None | $251.19 | $676.08 | $1,258.93 |
Oscar Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $147.91 Median $549.54 Typical High $1,230.27 | Professional | None | $147.91 | $549.54 | $1,230.27 |
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 $67.61 Median $223.87 Typical High $338.84 | Professional | 52 · Reduced service | $67.61 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $89.13 Typical High $134.90 | Professional | 53 · Discontinued | $26.92 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $338.84 Typical High $512.86 | Professional | 54 · Surgery only | $102.33 | $338.84 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $67.61 Typical High $102.33 | Professional | 55 · Aftercare only | $20.42 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $44.67 Typical High $67.61 | Professional | 56 · Pre-op care only | $13.49 | $44.67 | $67.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $1,230.27 Typical High $2,454.71 | Professional | 50 · Both sides | $371.54 | $1,230.27 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $407.38 Typical High $812.83 | Professional | 51 · Multiple procedures | $125.89 | $407.38 | $812.83 |
Where North Carolina sits
The same service costs 3.8 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· 38th of 51
$447
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.