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 $1,288.25 Typical High $8,317.64 | Facility | None | $131.83 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $1,288.25 | Professional | None | $131.83 | $131.83 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $3,981.07 | Facility | None | $1,995.26 | $2,951.21 | $3,981.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $416.87 | Professional | None | $199.53 | $288.40 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,265.80 Typical High $6,309.57 | Facility | None | $645.65 | $4,265.80 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $398.11 | Professional | None | $173.78 | $199.53 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $4,466.84 | Facility | None | $446.68 | $977.24 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $302.00 | Professional | None | $144.54 | $194.98 | $302.00 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,378.01 | Facility | None | $1,380.38 | $4,265.80 | $17,378.01 |
United Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $354.81 | Professional | None | $134.90 | $208.93 | $354.81 |
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 $66.07 Median $66.07 Typical High $83.18 | Professional | 52 · Reduced service | $66.07 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $26.30 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $97.72 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $16.60 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $831.76 Typical High $3,019.95 | Facility | 51 · Multiple procedures | $295.12 | $831.76 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $97.72 Typical High $190.55 | Professional | 51 · Multiple procedures | $72.44 | $97.72 | $190.55 |
Where North Carolina sits
The same service costs 17.8 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· 23rd of 51
$302
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.