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 $114.82 Median $1,318.26 Typical High $7,244.36 | Facility | None | $114.82 | $1,318.26 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $1,318.26 Typical High $1,995.26 | Professional | None | $114.82 | $1,318.26 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,905.46 | Professional | None | $954.99 | $1,122.02 | $1,905.46 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $4,365.16 | Facility | None | $1,096.48 | $1,737.80 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $199.53 Median $2,041.74 Typical High $4,168.69 | Professional | None | $199.53 | $2,041.74 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,754.23 | Facility | None | $602.56 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $1,202.26 Typical High $2,818.38 | Professional | None | $147.91 | $1,202.26 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $1,318.26 Typical High $2,137.96 | Facility | None | $138.04 | $1,318.26 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,548.82 | $2,137.96 | $2,398.83 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $131.83 Median $933.25 Typical High $3,019.95 | Professional | None | $131.83 | $933.25 | $3,019.95 |
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 $57.54 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $57.54 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $22.91 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $87.10 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $17.38 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $11.48 | $131.83 | $151.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,162.28 Typical High $5,888.44 | Professional | 50 · Both sides | $2,290.87 | $3,162.28 | $5,888.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $1,047.13 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $776.25 | $1,047.13 | $1,995.26 |
Where North Carolina sits
The same service costs 10.5 times more in Alaska than in Nebraska. 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· 10th of 51
$1,585
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.