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 $87.10 Median $257.04 Typical High $7,413.10 | Facility | None | $87.10 | $257.04 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $257.04 Typical High $346.74 | Professional | None | $87.10 | $257.04 | $346.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $151.36 Median $457.09 Typical High $691.83 | Professional | None | $151.36 | $457.09 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $2,187.76 | Facility | None | $478.63 | $602.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $316.23 Typical High $537.03 | Professional | None | $107.15 | $316.23 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $407.38 | Facility | None | $87.10 | $138.04 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $416.87 | Professional | None | $239.88 | $363.08 | $416.87 |
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 $95.50 Median $263.03 Typical High $588.84 | Professional | None | $95.50 | $263.03 | $588.84 |
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 $43.65 Median $70.79 Typical High $131.83 | Professional | 52 · Reduced service | $43.65 | $70.79 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.18 Typical High $53.70 | Professional | 53 · Discontinued | $17.38 | $28.18 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $104.71 Typical High $199.53 | Professional | 54 · Surgery only | $64.57 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $20.89 Typical High $39.81 | Professional | 55 · Aftercare only | $13.18 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.13 Typical High $26.30 | Professional | 56 · Pre-op care only | $8.71 | $14.13 | $26.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $549.54 Typical High $1,096.48 | Professional | 50 · Both sides | $363.08 | $549.54 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $181.97 Typical High $363.08 | Professional | 51 · Multiple procedures | $120.23 | $181.97 | $363.08 |
Where North Carolina sits
The same service costs 3.6 times more in Wisconsin 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· 9th of 51
$331
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.