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 $190.55 Median $281.84 Typical High $7,585.78 | Facility | None | $190.55 | $281.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $398.11 | Professional | None | $190.55 | $281.84 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $794.33 | Facility | None | $398.11 | $588.84 | $794.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $302.00 Median $588.84 Typical High $831.76 | Professional | None | $302.00 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $549.54 Typical High $1,737.80 | Facility | None | $354.81 | $549.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $660.69 | Professional | None | $239.88 | $302.00 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $954.99 | Facility | None | $309.03 | $407.38 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $467.74 | Professional | None | $239.88 | $371.54 | $467.74 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $660.69 | Professional | None | $204.17 | $309.03 | $660.69 |
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 $95.50 Median $141.25 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $194.98 | $218.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $257.04 Typical High $467.74 | Facility | 51 · Multiple procedures | $154.88 | $257.04 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $186.21 Typical High $416.87 | Professional | 51 · Multiple procedures | $120.23 | $186.21 | $416.87 |
Where North Carolina sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 9th of 51
$447
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.