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 $275.42 Median $363.08 Typical High $7,585.78 | Facility | None | $275.42 | $363.08 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $537.03 | Professional | None | $275.42 | $363.08 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,023.29 | Professional | None | $416.87 | $645.65 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,951.21 | Facility | None | $602.56 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $870.96 | Professional | None | $331.13 | $407.38 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $977.24 Typical High $2,454.71 | Facility | None | $436.52 | $977.24 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $602.56 | Professional | None | $323.59 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $870.96 | Professional | None | $288.40 | $407.38 | $870.96 |
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 $138.04 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $138.04 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $54.95 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $208.93 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $194.98 | $251.19 | $281.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $549.54 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $263.03 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $229.09 Typical High $537.03 | Professional | 51 · Multiple procedures | $162.18 | $229.09 | $537.03 |
Where North Carolina sits
The same service costs 4.9 times more in Alaska 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· 17th of 51
$550
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.