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 $131.83 Median $295.12 Typical High $7,413.10 | Facility | None | $131.83 | $295.12 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $549.54 | Professional | None | $131.83 | $295.12 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $5,754.40 | Facility | None | $1,445.44 | $2,290.87 | $5,754.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $630.96 Typical High $933.25 | Professional | None | $257.04 | $630.96 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $5,370.32 | Facility | None | $524.81 | $1,995.26 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $436.52 Typical High $691.83 | Professional | None | $199.53 | $436.52 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $1,412.54 Typical High $1,905.46 | Facility | None | $295.12 | $1,412.54 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $707.95 | Professional | None | $354.81 | $512.86 | $707.95 |
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 $154.88 Median $354.81 Typical High $758.58 | Professional | None | $154.88 | $354.81 | $758.58 |
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 $100.00 Median $169.82 Typical High $234.42 | Professional | 54 · Surgery only | $100.00 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $33.88 Typical High $46.77 | Professional | 55 · Aftercare only | $19.95 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.39 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.18 | $22.39 | $30.90 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,819.70 Median $2,344.23 Typical High $3,801.89 | Facility | 50 · Both sides | $1,819.70 | $2,344.23 | $3,801.89 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $602.56 Median $776.25 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $602.56 | $776.25 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $1,047.13 Typical High $1,318.26 | Professional | 50 · Both sides | $562.34 | $1,047.13 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $346.74 Typical High $436.52 | Professional | 51 · Multiple procedures | $186.21 | $346.74 | $436.52 |
Where North Carolina sits
The same service costs 3.4 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· 8th of 51
$457
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.