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 $181.97 Typical High $7,585.78 | Facility | None | $107.15 | $181.97 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $199.53 | Professional | None | $107.15 | $173.78 | $199.53 |
BCBS North Carolina Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Facility | None | $112.20 | $165.96 | $223.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $489.78 | Professional | None | $158.49 | $251.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $758.58 | Facility | None | $158.49 | $257.04 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $295.12 | Professional | None | $120.23 | $165.96 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $446.68 | Professional | None | $229.09 | $229.09 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $724.44 | Facility | None | $134.90 | $245.47 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $229.09 | Professional | None | $173.78 | $177.83 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | None | $162.18 | $162.18 | $173.78 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $263.03 | Professional | None | $104.71 | $158.49 | $263.03 |
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 $53.70 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $53.70 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $33.88 Typical High $38.02 | Professional | 53 · Discontinued | $21.38 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $141.25 | Professional | 54 · Surgery only | $79.43 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.12 Typical High $28.18 | Professional | 55 · Aftercare only | $16.22 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.72 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $117.49 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $74.13 | $117.49 | $131.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $67.61 Median $158.49 Typical High $363.08 | Facility | 51 · Multiple procedures | $67.61 | $158.49 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $89.13 Typical High $117.49 | Professional | 51 · Multiple procedures | $87.10 | $89.13 | $117.49 |
Where North Carolina sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 12th of 51
$234
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.