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 $83.18 Median $190.55 Typical High $7,413.10 | Facility | None | $83.18 | $190.55 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $331.13 | Professional | None | $83.18 | $190.55 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $436.52 Typical High $436.52 | Professional | None | $85.11 | $436.52 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $2,398.83 | Facility | None | $602.56 | $933.25 | $2,398.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $190.55 Median $446.68 Typical High $676.08 | Professional | None | $190.55 | $446.68 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,235.94 | Facility | None | $457.09 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $263.03 Typical High $478.63 | Professional | None | $128.82 | $263.03 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $478.63 Typical High $2,137.96 | Facility | None | $223.87 | $478.63 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $524.81 | Professional | None | $204.17 | $338.84 | $524.81 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $478.63 | Professional | None | $114.82 | $229.09 | $478.63 |
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 $41.69 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $41.69 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $33.88 Typical High $39.81 | Professional | 53 · Discontinued | $16.60 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $63.10 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $12.59 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $16.98 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.32 | $16.98 | $19.95 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $257.04 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $186.21 | $257.04 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $234.42 Typical High $263.03 | Professional | 51 · Multiple procedures | $123.03 | $234.42 | $263.03 |
Where North Carolina sits
The same service costs 4.1 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
$363
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.