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 $1,288.25 Median $1,380.38 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,380.38 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,380.38 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,570.40 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,949.84 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $5,128.61 | Facility | None | $1,380.38 | $1,659.59 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,659.59 | $2,238.72 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,905.46 | $3,801.89 |
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 $691.83 Median $691.83 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $851.14 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $660.69 | $851.14 | $1,995.26 |
Where North Carolina sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 14th of 51
$2,344
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.