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 $7,585.78 | Facility | None | $346.74 | $1,995.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $2,691.53 | Professional | None | $346.74 | $1,584.89 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $758.58 Median $2,511.89 Typical High $6,165.95 | Professional | None | $758.58 | $2,511.89 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,258.93 Typical High $4,365.16 | Professional | None | $489.78 | $1,258.93 | $4,365.16 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $2,137.96 | Facility | None | $346.74 | $346.74 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,570.40 | $2,951.21 | $4,466.84 |
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 $371.54 Median $1,949.84 Typical High $4,466.84 | Professional | None | $371.54 | $1,949.84 | $4,466.84 |
6 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 $831.76 Typical High $1,230.27 | Professional | 52 · Reduced service | $173.78 | $831.76 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $331.13 Typical High $489.78 | Professional | 53 · Discontinued | $69.18 | $331.13 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $1,230.27 Typical High $1,819.70 | Professional | 54 · Surgery only | $257.04 | $1,230.27 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $245.47 Typical High $363.08 | Professional | 55 · Aftercare only | $51.29 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $165.96 Typical High $245.47 | Professional | 56 · Pre-op care only | $34.67 | $165.96 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,479.11 Median $1,479.11 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,479.11 | $1,479.11 | $2,884.03 |
Where North Carolina sits
The same service costs 6.9 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· 23rd 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.