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 $107.15 Median $229.09 Typical High $7,585.78 | Facility | None | $107.15 | $229.09 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $309.03 | Professional | None | $107.15 | $229.09 | $309.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $501.19 | Facility | None | $125.89 | $194.98 | $501.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $549.54 | Professional | None | $165.96 | $269.15 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,819.70 | Facility | None | $602.56 | $1,071.52 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $478.63 | Professional | None | $123.03 | $194.98 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $524.81 Typical High $977.24 | Facility | None | $107.15 | $524.81 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $371.54 | Professional | None | $218.78 | $281.84 | $371.54 |
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 $223.87 Typical High $524.81 | Professional | None | $114.82 | $223.87 | $524.81 |
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 $53.70 Median $89.13 Typical High $120.23 | Professional | 52 · Reduced service | $53.70 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $35.48 Typical High $47.86 | Professional | 53 · Discontinued | $21.38 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $81.28 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.78 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.72 | $17.78 | $23.99 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $53.70 Median $281.84 Typical High $489.78 | Facility | 51 · Multiple procedures | $53.70 | $281.84 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $138.04 Typical High $338.84 | Professional | 51 · Multiple procedures | $107.15 | $138.04 | $338.84 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 32nd of 51
$269
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.