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 $134.90 Typical High $7,413.10 | Facility | None | $87.10 | $134.90 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $186.21 | Professional | None | $87.10 | $134.90 | $186.21 |
BCBS North Carolina Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $389.05 | Professional | None | $141.25 | $239.88 | $389.05 |
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 $109.65 Median $173.78 Typical High $295.12 | Professional | None | $109.65 | $173.78 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $213.80 | Facility | None | $87.10 | $134.90 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $218.78 | Professional | None | $125.89 | $190.55 | $218.78 |
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 $169.82 Typical High $338.84 | Professional | None | $95.50 | $169.82 | $338.84 |
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 $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $43.65 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $17.38 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $64.57 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.95 Typical High $23.44 | Professional | 55 · Aftercare only | $13.18 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.71 | $13.49 | $15.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $288.40 Typical High $602.56 | Professional | 50 · Both sides | $190.55 | $288.40 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $95.50 Typical High $199.53 | Professional | 51 · Multiple procedures | $63.10 | $95.50 | $199.53 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$200
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.