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 $123.03 Median $1,000.00 Typical High $7,943.28 | Facility | None | $123.03 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $741.31 | Facility | None | $186.21 | $288.40 | $741.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $363.08 | Professional | None | $169.82 | $229.09 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $776.25 | Facility | None | $288.40 | $416.87 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $263.03 | Professional | None | $151.36 | $158.49 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | None | $229.09 | $229.09 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $524.81 | Facility | None | $158.49 | $251.19 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $223.87 | Professional | None | $114.82 | $165.96 | $223.87 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | None | $169.82 | $169.82 | $177.83 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $239.88 | Professional | None | $112.20 | $144.54 | $239.88 |
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 $61.66 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $15.49 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $79.43 Median $125.89 Typical High $263.03 | Facility | 51 · Multiple procedures | $79.43 | $125.89 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $83.18 Typical High $125.89 | Professional | 51 · Multiple procedures | $57.54 | $83.18 | $125.89 |
Where North Carolina sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 12th of 51
$224
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.