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 $56.23 Median $72.44 Typical High $7,413.10 | Facility | None | $56.23 | $72.44 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $89.13 | Professional | None | $56.23 | $72.44 | $89.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $54.95 Median $85.11 Typical High $218.78 | Facility | None | $54.95 | $85.11 | $218.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $229.09 | Professional | None | $83.18 | $134.90 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $91.20 Typical High $524.81 | Facility | None | $57.54 | $91.20 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $141.25 | Professional | None | $64.57 | $83.18 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $186.21 | Professional | None | $117.49 | $117.49 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $138.04 | Facility | None | $64.57 | $100.00 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $100.00 | Professional | None | $70.79 | $89.13 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | None | $77.62 | $77.62 | $81.28 |
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 $56.23 Median $77.62 Typical High $125.89 | Professional | None | $56.23 | $77.62 | $125.89 |
7 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 $28.18 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $28.18 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $15.49 | Professional | 53 · Discontinued | $11.22 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $54.95 Typical High $57.54 | Professional | 54 · Surgery only | $42.66 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $7.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $32.36 Median $50.12 Typical High $69.18 | Facility | 51 · Multiple procedures | $32.36 | $50.12 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $44.67 Typical High $54.95 | Professional | 51 · Multiple procedures | $35.48 | $44.67 | $54.95 |
Where North Carolina sits
The same service costs 4.3 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· 7th of 51
$135
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.