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 $151.36 Median $208.93 Typical High $7,413.10 | Facility | None | $151.36 | $208.93 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $239.88 | Professional | None | $151.36 | $208.93 | $239.88 |
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 $213.80 Median $354.81 Typical High $575.44 | Professional | None | $213.80 | $354.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,348.96 | Facility | None | $457.09 | $1,071.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $363.08 | Professional | None | $165.96 | $208.93 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $524.81 | Professional | None | $295.12 | $295.12 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $977.24 | Facility | None | $239.88 | $389.05 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $269.15 | Professional | None | $204.17 | $218.78 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
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 $147.91 Median $204.17 Typical High $331.13 | Professional | None | $147.91 | $204.17 | $331.13 |
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 $75.86 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $30.20 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $151.36 Typical High $162.18 | Professional | 54 · Surgery only | $112.20 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $22.91 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $141.25 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $104.71 | $141.25 | $151.36 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $223.87 Typical High $758.58 | Facility | 51 · Multiple procedures | $154.88 | $223.87 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $109.65 Typical High $151.36 | Professional | 51 · Multiple procedures | $102.33 | $109.65 | $151.36 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in New Jersey. 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
$316
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.