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 $104.71 Median $1,148.15 Typical High $7,943.28 | Facility | None | $104.71 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $147.91 | Professional | None | $104.71 | $104.71 | $147.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $630.96 Median $933.25 Typical High $1,258.93 | Facility | None | $630.96 | $933.25 | $1,258.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $75.86 Median $181.97 Typical High $309.03 | Professional | None | $75.86 | $181.97 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $446.68 Typical High $812.83 | Facility | None | $288.40 | $446.68 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $213.80 | Professional | None | $109.65 | $114.82 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $245.47 | Professional | None | $169.82 | $169.82 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $676.08 Typical High $912.01 | Facility | None | $177.83 | $676.08 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $162.18 | Professional | None | $100.00 | $125.89 | $162.18 |
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 $91.20 Median $120.23 Typical High $208.93 | Professional | None | $91.20 | $120.23 | $208.93 |
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 $52.48 Median $52.48 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $97.72 | Professional | 54 · Surgery only | $77.62 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $19.50 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $13.18 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $158.49 Median $338.84 Typical High $457.09 | Facility | 51 · Multiple procedures | $158.49 | $338.84 | $457.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $63.10 Typical High $81.28 | Professional | 51 · Multiple procedures | $50.12 | $63.10 | $81.28 |
Where North Carolina sits
The same service costs 4.8 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· 16th of 51
$162
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.