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 $134.90 Median $1,288.25 Typical High $8,317.64 | Facility | None | $134.90 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $1,047.13 | Professional | None | $134.90 | $134.90 | $1,047.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $8,128.31 | Facility | None | $2,041.74 | $3,162.28 | $8,128.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $426.58 | Professional | None | $154.88 | $263.03 | $426.58 |
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 $177.83 Median $204.17 Typical High $398.11 | Professional | None | $177.83 | $204.17 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $5,888.44 | Facility | None | $446.68 | $977.24 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $316.23 | Professional | None | $144.54 | $194.98 | $316.23 |
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 $138.04 Median $213.80 Typical High $371.54 | Professional | None | $138.04 | $213.80 | $371.54 |
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 $67.61 Median $67.61 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | 53 · Discontinued | $26.92 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $102.33 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $17.38 |
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 $100.00 Typical High $199.53 | Professional | 51 · Multiple procedures | $72.44 | $100.00 | $199.53 |
Where North Carolina sits
The same service costs 20.4 times more in Kansas 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· 28th of 51
$282
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.