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 $234.42 Median $1,230.27 Typical High $7,413.10 | Facility | None | $234.42 | $1,230.27 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $912.01 Typical High $1,698.24 | Professional | None | $234.42 | $912.01 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $446.68 Median $1,949.84 Typical High $3,467.37 | Professional | None | $446.68 | $1,949.84 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $977.24 Typical High $2,691.53 | Professional | None | $281.84 | $977.24 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $1,698.24 | Facility | None | $234.42 | $245.47 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,548.82 | $2,344.23 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $239.88 Median $1,122.02 Typical High $2,630.27 | Professional | None | $239.88 | $1,122.02 | $2,630.27 |
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 $117.49 Median $457.09 Typical High $707.95 | Professional | 52 · Reduced service | $117.49 | $457.09 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $181.97 Typical High $281.84 | Professional | 53 · Discontinued | $46.77 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $691.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $177.83 | $691.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $138.04 Typical High $213.80 | Professional | 55 · Aftercare only | $35.48 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $91.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $23.44 | $91.20 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $2,344.23 Typical High $5,495.41 | Professional | 50 · Both sides | $2,344.23 | $2,344.23 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $776.25 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $776.25 | $776.25 | $1,819.70 |
Where North Carolina sits
The same service costs 6.5 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· 2nd of 51
$1,950
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.