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 $245.47 Median $831.76 Typical High $5,248.07 | Facility | None | $245.47 | $831.76 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $794.33 Typical High $1,412.54 | Professional | None | $245.47 | $794.33 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $691.83 Typical High $1,737.80 | Professional | None | $354.81 | $691.83 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $2,818.38 | Professional | None | $478.63 | $851.14 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $794.33 Typical High $2,089.30 | Professional | None | $316.23 | $794.33 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $891.25 | Facility | None | $245.47 | $245.47 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $1,000.00 Typical High $1,819.70 | Professional | None | $436.52 | $1,000.00 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $263.03 Median $812.83 Typical High $1,949.84 | Professional | None | $263.03 | $812.83 | $1,949.84 |
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 $123.03 Median $316.23 Typical High $478.63 | Professional | 52 · Reduced service | $123.03 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $125.89 Typical High $194.98 | Professional | 53 · Discontinued | $48.98 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $478.63 Typical High $724.44 | Professional | 54 · Surgery only | $181.97 | $478.63 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $95.50 Typical High $144.54 | Professional | 55 · Aftercare only | $37.15 | $95.50 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $63.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $24.55 | $63.10 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $2,238.72 Typical High $3,548.13 | Professional | 50 · Both sides | $660.69 | $2,238.72 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $758.58 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $218.78 | $758.58 | $1,174.90 |
Where North Carolina sits
The same service costs 4.3 times more in Wisconsin 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· 19th of 51
$851
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.