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 $309.03 Median $1,513.56 Typical High $7,585.78 | Facility | None | $309.03 | $1,513.56 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,148.15 Typical High $2,089.30 | Professional | None | $309.03 | $1,148.15 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $398.11 Typical High $398.11 | Professional | None | $141.25 | $398.11 | $398.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $630.96 Median $1,949.84 Typical High $4,168.69 | Professional | None | $630.96 | $1,949.84 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,258.93 Typical High $3,162.28 | Professional | None | $398.11 | $1,258.93 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $323.59 Typical High $1,995.26 | Facility | None | $309.03 | $323.59 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,041.74 | $2,951.21 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $316.23 Median $1,445.44 Typical High $3,235.94 | Professional | None | $316.23 | $1,445.44 | $3,235.94 |
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 $154.88 Median $524.81 Typical High $812.83 | Professional | 52 · Reduced service | $154.88 | $524.81 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $213.80 Typical High $323.59 | Professional | 53 · Discontinued | $61.66 | $213.80 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $794.33 Typical High $1,230.27 | Professional | 54 · Surgery only | $234.42 | $794.33 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $158.49 Typical High $245.47 | Professional | 55 · Aftercare only | $46.77 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $104.71 Typical High $162.18 | Professional | 56 · Pre-op care only | $30.90 | $104.71 | $162.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,090.30 Typical High $6,309.57 | Professional | 50 · Both sides | $3,090.30 | $3,090.30 | $6,309.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,023.29 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,023.29 | $1,023.29 | $2,089.30 |
Where North Carolina sits
The same service costs 5.6 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· 27th of 51
$1,514
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.