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 $269.15 Median $977.24 Typical High $7,943.28 | Facility | None | $269.15 | $977.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $977.24 Typical High $1,659.59 | Professional | None | $269.15 | $977.24 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,698.24 | Professional | None | $724.44 | $851.14 | $1,698.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,884.03 | Facility | None | $1,412.54 | $2,089.30 | $2,884.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $2,511.89 Typical High $3,630.78 | Professional | None | $524.81 | $2,511.89 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $5,128.61 | Facility | None | $1,548.82 | $2,691.53 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,288.25 Typical High $2,818.38 | Professional | None | $398.11 | $1,288.25 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $3,467.37 | Facility | None | $1,096.48 | $1,584.89 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,230.27 | $1,819.70 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $316.23 Median $1,023.29 Typical High $2,630.27 | Professional | None | $316.23 | $1,023.29 | $2,630.27 |
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 54 · Surgery only Typical Low $204.17 Median $371.54 Typical High $776.25 | Professional | 54 · Surgery only | $204.17 | $371.54 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $74.13 Typical High $154.88 | Professional | 55 · Aftercare only | $40.74 | $74.13 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $50.12 Typical High $102.33 | Professional | 56 · Pre-op care only | $26.92 | $50.12 | $102.33 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,819.70 Median $2,454.71 Typical High $5,248.07 | Facility | 50 · Both sides | $1,819.70 | $2,454.71 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $602.56 Median $831.76 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $602.56 | $831.76 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $4,265.80 Typical High $5,623.41 | Professional | 50 · Both sides | $2,398.83 | $4,265.80 | $5,623.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $1,412.54 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $794.33 | $1,412.54 | $1,862.09 |
Where North Carolina sits
The same service costs 4.8 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· 9th of 51
$1,660
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.