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 $165.96 Median $707.95 Typical High $4,265.80 | Facility | None | $165.96 | $707.95 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $524.81 Typical High $954.99 | Professional | None | $165.96 | $524.81 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $1,096.48 | Professional | None | $173.78 | $245.47 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $489.78 Median $724.44 Typical High $977.24 | Facility | None | $489.78 | $724.44 | $977.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $602.56 Typical High $1,659.59 | Professional | None | $295.12 | $602.56 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,479.11 | Facility | None | $524.81 | $891.25 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $537.03 Typical High $1,258.93 | Professional | None | $181.97 | $537.03 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $851.14 Typical High $1,412.54 | Facility | None | $194.98 | $851.14 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,096.48 | Professional | None | $660.69 | $758.58 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $169.82 Median $575.44 Typical High $1,258.93 | Professional | None | $169.82 | $575.44 | $1,258.93 |
6 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 $81.28 Median $208.93 Typical High $354.81 | Professional | 52 · Reduced service | $81.28 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $83.18 Typical High $144.54 | Professional | 53 · Discontinued | $33.11 | $83.18 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $309.03 Typical High $537.03 | Professional | 54 · Surgery only | $123.03 | $309.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $61.66 Typical High $107.15 | Professional | 55 · Aftercare only | $24.55 | $61.66 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $41.69 Typical High $72.44 | Professional | 56 · Pre-op care only | $16.60 | $41.69 | $72.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $380.19 Typical High $954.99 | Professional | 51 · Multiple procedures | $380.19 | $380.19 | $954.99 |
Where North Carolina sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 21st of 51
$661
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.