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 $229.09 Median $1,230.27 Typical High $5,248.07 | Facility | None | $229.09 | $1,230.27 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $1,000.00 Typical High $1,737.80 | Professional | None | $229.09 | $1,000.00 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $3,467.37 | Professional | None | $436.52 | $891.25 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $812.83 Typical High $2,570.40 | Professional | None | $288.40 | $812.83 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $1,318.26 | Facility | None | $229.09 | $234.42 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $1,548.82 Typical High $2,691.53 | Professional | None | $389.05 | $1,548.82 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $1,000.00 Typical High $2,630.27 | Professional | None | $239.88 | $1,000.00 | $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 $114.82 Median $501.19 Typical High $724.44 | Professional | 52 · Reduced service | $114.82 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $199.53 Typical High $295.12 | Professional | 53 · Discontinued | $45.71 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $741.31 Typical High $1,096.48 | Professional | 54 · Surgery only | $169.82 | $741.31 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $147.91 Typical High $218.78 | Professional | 55 · Aftercare only | $34.67 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $22.91 | $100.00 | $144.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $2,344.23 Typical High $5,370.32 | Professional | 50 · Both sides | $588.84 | $2,344.23 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $776.25 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $194.98 | $776.25 | $1,778.28 |
Where North Carolina sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 36th of 51
$891
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.