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 $346.74 Median $1,995.26 Typical High $6,760.83 | Facility | None | $346.74 | $1,995.26 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,380.38 Typical High $2,754.23 | Professional | None | $346.74 | $1,380.38 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $489.78 | Professional | None | $245.47 | $446.68 | $489.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $2,238.72 Typical High $5,011.87 | Professional | None | $691.83 | $2,238.72 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,445.44 Typical High $4,073.80 | Professional | None | $436.52 | $1,445.44 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $363.08 Typical High $2,630.27 | Facility | None | $346.74 | $363.08 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,238.72 | $3,715.35 |
Oscar Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $9,772.37 Median $16,982.44 Typical High $26,915.35 | Facility | None | $9,772.37 | $16,982.44 | $26,915.35 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,584.89 Typical High $3,890.45 | Professional | None | $354.81 | $1,584.89 | $3,890.45 |
8 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 $173.78 Median $691.83 Typical High $1,071.52 | Professional | 52 · Reduced service | $173.78 | $691.83 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $275.42 Typical High $426.58 | Professional | 53 · Discontinued | $70.79 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,023.29 Typical High $1,584.89 | Professional | 54 · Surgery only | $263.03 | $1,023.29 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $204.17 Typical High $316.23 | Professional | 55 · Aftercare only | $52.48 | $204.17 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $138.04 Typical High $213.80 | Professional | 56 · Pre-op care only | $34.67 | $138.04 | $213.80 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $562.34 Typical High $741.31 | Professional | 50 · Both sides | $371.54 | $562.34 | $741.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $3,388.44 Typical High $8,511.38 | Professional | 50 · Both sides | $3,388.44 | $3,388.44 | $8,511.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,122.02 Typical High $2,818.38 | Professional | 51 · Multiple procedures | $1,122.02 | $1,122.02 | $2,818.38 |
Where North Carolina sits
The same service costs 6.3 times more in Washington 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· 16th of 51
$1,995
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.