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 $316.23 Median $1,737.80 Typical High $7,585.78 | Facility | None | $316.23 | $1,737.80 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $1,288.25 Typical High $2,454.71 | Professional | None | $316.23 | $1,288.25 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $1,445.44 Typical High $5,623.41 | Professional | None | $602.56 | $1,445.44 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,122.02 Typical High $3,981.07 | Professional | None | $380.19 | $1,122.02 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $331.13 Typical High $2,187.76 | Facility | None | $316.23 | $331.13 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $2,187.76 Typical High $4,073.80 | Professional | None | $524.81 | $2,187.76 | $4,073.80 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $331.13 Median $1,412.54 Typical High $3,981.07 | Professional | None | $331.13 | $1,412.54 | $3,981.07 |
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 $158.49 Median $691.83 Typical High $1,047.13 | Professional | 52 · Reduced service | $158.49 | $691.83 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $275.42 Typical High $416.87 | Professional | 53 · Discontinued | $63.10 | $275.42 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $1,023.29 Typical High $1,548.82 | Professional | 54 · Surgery only | $239.88 | $1,023.29 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $204.17 Typical High $309.03 | Professional | 55 · Aftercare only | $47.86 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $138.04 Typical High $208.93 | Professional | 56 · Pre-op care only | $31.62 | $138.04 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $1,258.93 Typical High $2,570.40 | Professional | 51 · Multiple procedures | $263.03 | $1,258.93 | $2,570.40 |
Where North Carolina sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 31st of 51
$1,445
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.