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 $467.74 Median $1,288.25 Typical High $10,471.29 | Facility | None | $467.74 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,288.25 | Professional | None | $467.74 | $467.74 | $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 $467.74 Median $870.96 Typical High $1,380.38 | Professional | None | $467.74 | $870.96 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,570.88 | Facility | None | $794.33 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,288.25 | Professional | None | $524.81 | $691.83 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $3,548.13 | Facility | None | $707.95 | $1,659.59 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $794.33 | Professional | None | $446.68 | $575.44 | $794.33 |
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 $478.63 Median $676.08 Typical High $1,288.25 | Professional | None | $478.63 | $676.08 | $1,288.25 |
8 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 $234.42 Median $234.42 Typical High $309.03 | Professional | 52 · Reduced service | $234.42 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | 53 · Discontinued | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $831.76 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $363.08 | $831.76 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $309.03 Typical High $676.08 | Professional | 51 · Multiple procedures | $223.87 | $309.03 | $676.08 |
Where North Carolina sits
The same service costs 5.4 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· 26th of 51
$891
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.