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 $275.42 Median $1,202.26 Typical High $7,585.78 | Facility | None | $275.42 | $1,202.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $933.25 Typical High $1,584.89 | Professional | None | $275.42 | $933.25 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $1,737.80 Typical High $3,715.35 | Professional | None | $575.44 | $1,737.80 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,047.13 Typical High $2,691.53 | Professional | None | $371.54 | $1,047.13 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $1,412.54 | Facility | None | $275.42 | $281.84 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,862.09 | $2,570.40 |
Oscar Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $6,456.54 Median $10,964.78 Typical High $16,982.44 | Facility | None | $6,456.54 | $10,964.78 | $16,982.44 |
United Setting Professional Modifier None Typical Low $288.40 Median $1,202.26 Typical High $2,691.53 | Professional | None | $288.40 | $1,202.26 | $2,691.53 |
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 $138.04 Median $457.09 Typical High $707.95 | Professional | 52 · Reduced service | $138.04 | $457.09 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $181.97 Typical High $281.84 | Professional | 53 · Discontinued | $54.95 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $676.08 Typical High $1,071.52 | Professional | 54 · Surgery only | $208.93 | $676.08 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $138.04 Typical High $213.80 | Professional | 55 · Aftercare only | $41.69 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $91.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $27.54 | $91.20 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $2,818.38 Typical High $5,128.61 | Professional | 50 · Both sides | $2,818.38 | $2,818.38 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $933.25 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $933.25 | $933.25 | $1,698.24 |
Where North Carolina sits
The same service costs 5.1 times more in Wisconsin than in Maryland. 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
$1,202
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.