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 $112.20 Median $1,000.00 Typical High $7,943.28 | Facility | None | $112.20 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $870.96 | Professional | None | $112.20 | $112.20 | $870.96 |
BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $6,606.93 | Facility | None | $1,659.59 | $2,570.40 | $6,606.93 |
BCBS Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $363.08 | Professional | None | $123.03 | $213.80 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,754.23 Typical High $4,073.80 | Facility | None | $457.09 | $2,754.23 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $323.59 | Professional | None | $141.25 | $169.82 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $2,454.71 | Facility | None | $371.54 | $602.56 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $251.19 | Professional | None | $114.82 | $141.25 | $251.19 |
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 $114.82 Median $169.82 Typical High $316.23 | Professional | None | $114.82 | $169.82 | $316.23 |
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 $56.23 Median $56.23 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $22.91 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 54 · Surgery only | $85.11 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $15.85 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $691.83 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $186.21 | $691.83 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $79.43 Typical High $165.96 | Professional | 51 · Multiple procedures | $57.54 | $79.43 | $165.96 |
Where North Carolina sits
The same service costs 12.9 times more in Arkansas than in New York. 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· 25th of 51
$240
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.